Provider Demographics
NPI:1629571468
Name:MH CONSUMER DIRECTED SERVICES LLC
Entity type:Organization
Organization Name:MH CONSUMER DIRECTED SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-203-1038
Mailing Address - Street 1:9519 WINKLER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-2919
Mailing Address - Country:US
Mailing Address - Phone:314-497-2918
Mailing Address - Fax:
Practice Address - Street 1:9519 WINKLER DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-2919
Practice Address - Country:US
Practice Address - Phone:314-497-2918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health