Organization
BLUE HAYVEN IN-HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE BROCK-WILLIAMS (OWNER)
(314) 395-6121
Entity
Organization
Contact information
Practice address
11553 WITHERSFIELD DR, SAINT LOUIS, MO 63138-1152
(314) 395-6121
(314) 395-6121
Mailing address
11553 WITHERSFIELD DR, SAINT LOUIS, MO 63138-1152
(314) 395-6121
(314) 395-6121
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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