Gracious Love In Home Services LLC
In Home Supportive Care in Ferguson, MO. Organization (NPI-2).
NPI number1407521883
StatusActive
Last updated in NPPESAug 9, 2021
Details
- NPI
- 1407521883
- Entity type
- Organization (NPI-2)
- Legal business name
- Gracious Love In Home Services LLC
- Organization subpart
- No
- Enumeration date
- Aug 9, 2021
- Certification date
- Aug 9, 2021
- Last updated
- Aug 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
Practice location
267 S Dade AveFerguson, MO 63135-2522
Phone 618-477-6535
Mailing address
267 S Dade AveFerguson, MO 63135-2522
Phone 618-477-6535
Authorized official
Debralle Wilkins
President/Administrator
6184476535
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