Organization
JETTIE B'S HEALTH CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHAKITA COBURN (OWNER)
(314) 551-2079
Entity
Organization
Contact information
Practice address
10420 OLD OLIVE STREET RD STE 206, SAINT LOUIS, MO 63141-5937
(314) 551-2079
Mailing address
10420 OLD OLIVE STREET RD STE 206, SAINT LOUIS, MO 63141-5937
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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