Organization · NPI-2

1st Assurance Consumer Direct Services, LLC

Home Health · Saint Louis, MO

NPI number1215401203
StatusActive
Last updated in NPPESJan 14, 2019

Details

NPI
1215401203
Entity type
Organization (NPI-2)
Legal business name
1st Assurance Consumer Direct Services, LLC
Organization subpart
No
Enumeration date
Jan 14, 2019
Last updated
Jan 14, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health––Yes

Practice location

5057 Gravois Ave
Saint Louis, MO 63116-2342

Phone 314-390-0951

Mailing address

5057 Gravois Ave
Saint Louis, MO 63116-2342

Authorized official

Desola Nunley
Owner
3143900951

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