Vanessa Williams
Custodial Care Facility, Adult Care Home in Saint Louis, MO. Individual provider (NPI-1).
NPI number1053781443
StatusActive
Last updated in NPPESSep 29, 2015
Details
- NPI
- 1053781443
- Entity type
- Individual (NPI-1)
- Name
- Vanessa Williams
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 29, 2015
- Last updated
- Sep 29, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | – | – | Yes |
Practice location
5757 Park LnSaint Louis, MO 63147-1019
Phone 314-498-8539
Mailing address
5757 Park LnSaint Louis, MO 63147-1019
Phone 314-498-8539
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