Provider Demographics
NPI:1972323582
Name:DELIGHTFUL LIVING HOME HEALTH LLC
Entity type:Organization
Organization Name:DELIGHTFUL LIVING HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROSHONA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANKS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:314-365-0083
Mailing Address - Street 1:111 CHURCH ST STE 208A
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2438
Mailing Address - Country:US
Mailing Address - Phone:314-365-0083
Mailing Address - Fax:314-463-4366
Practice Address - Street 1:111 CHURCH ST STE 208A
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2438
Practice Address - Country:US
Practice Address - Phone:314-365-0083
Practice Address - Fax:314-463-4366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty