Provider Demographics
NPI:1740717263
Name:MAJOR LEAGUE HOME HEALTH LLC
Entity type:Organization
Organization Name:MAJOR LEAGUE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONNESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-817-6484
Mailing Address - Street 1:2907 DELMAR BLVD # A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-1316
Mailing Address - Country:US
Mailing Address - Phone:314-817-6484
Mailing Address - Fax:
Practice Address - Street 1:2907 DELMAR BLVD # A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1316
Practice Address - Country:US
Practice Address - Phone:314-817-6484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health