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Organization

ADVANTAGE CONSUMER DIRECTED SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BOSEN P JOHN (CEO)
(314) 282-2957
Entity
Organization

Contact information

Practice address
11796 WESTLINE INDUSTRIAL DR, SAINT LOUIS, MO 63146-3402
(314) 282-2957
(314) 282-2967
Mailing address
11796 WESTLINE INDUSTRIAL DR, SAINT LOUIS, MO 63146-3402
(314) 282-2957
(314) 282-2967

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0008753
MO
05
266270008
MO
05
286270004
MO
Enumeration date
05/02/2007
Last updated
03/02/2022
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