Provider Demographics
NPI:1316677917
Name:CDS OF SAINT LOUIS LLC
Entity type:Organization
Organization Name:CDS OF SAINT LOUIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEKAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-275-1075
Mailing Address - Street 1:2705 DOUGHERTY FERRY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3372
Mailing Address - Country:US
Mailing Address - Phone:314-858-9093
Mailing Address - Fax:
Practice Address - Street 1:2705 DOUGHERTY FERRY RD STE 200
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3372
Practice Address - Country:US
Practice Address - Phone:314-858-9093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health