Organization
INFINITI HOMECARE CONSUMER DIRECTED SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA CHARISSE BRADLEY R.N. (OWNER)
(314) 479-6121
Entity
Organization
Contact information
Practice address
4135 HOLMAN LN, SAINT LOUIS, MO 63134-3925
(314) 479-6121
(314) 423-1021
Mailing address
4135 HOLMAN LN, SAINT LOUIS, MO 63134-3925
(314) 479-6121
(314) 423-1021
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/02/2013
Last updated
05/02/2013
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