Provider Demographics
NPI:1144958687
Name:ANGELS OF ST LOUIS LLC
Entity type:Organization
Organization Name:ANGELS OF ST LOUIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:636-386-5067
Mailing Address - Street 1:14850 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7886
Mailing Address - Country:US
Mailing Address - Phone:636-386-5067
Mailing Address - Fax:636-386-5068
Practice Address - Street 1:14850 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7886
Practice Address - Country:US
Practice Address - Phone:636-386-5067
Practice Address - Fax:636-386-5068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health