Organization
BUNDLES OF LOVE IN HOME SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TEQUILA DIONTA CLARK (OWNER)
(314) 696-8600
Entity
Organization
Contact information
Practice address
501 N TAYLOR AVE, SAINT LOUIS, MO 63108-1810
(314) 696-8600
(314) 696-8899
Mailing address
501 N TAYLOR AVE, SAINT LOUIS, MO 63108-1810
(314) 696-8600
(314) 696-8899
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
LC9819745
MO
253Z00000X
In Home Supportive Care Agency
Primary
LC9819745
MO
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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