Provider Demographics
NPI:1881369031
Name:DIVIDE & CONQUER SERVICES, LLC.
Entity type:Organization
Organization Name:DIVIDE & CONQUER SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-459-0683
Mailing Address - Street 1:117 S LEXINGTON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-2444
Mailing Address - Country:US
Mailing Address - Phone:314-459-0683
Mailing Address - Fax:
Practice Address - Street 1:3510 ITASKA ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-1426
Practice Address - Country:US
Practice Address - Phone:314-459-0683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health