Organization
BRYANT'S & KING'S ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMONA LASHELLE EWHAREKUKO (PROVIDER)
(314) 526-1352
Entity
Organization
Contact information
Practice address
2162 CHERRY AVE, SAINT LOUIS, MO 63121-5625
(314) 526-1352
Mailing address
2162 CHERRY AVE, HILLSDALE, MO 63121
(314) 526-1352
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
S137338040
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-1693183
BLUE CROSS, BLUE SHIELD, ATENA,KAISER-PERMANENTE
MO
01
—
47-1693183
BLUE CROSS, BLUE SHIELD, ATENA,KAISER-PERMANENTE
—
Enumeration date
11/26/2014
Last updated
11/26/2014
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