Provider Demographics
NPI:1669839122
Name:VISIONS OF SAINT LOUIS LLC
Entity Type:Organization
Organization Name:VISIONS OF SAINT LOUIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CDS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-366-0360
Mailing Address - Street 1:9772 VICKIE PL
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-1911
Mailing Address - Country:US
Mailing Address - Phone:314-366-0360
Mailing Address - Fax:
Practice Address - Street 1:9772 VICKIE PL
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-1911
Practice Address - Country:US
Practice Address - Phone:314-366-0360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health