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Kenyatta Clark
Home Health Agency in Saint Louis, Missouri
NPI 1922879121

Kenyatta Clark is a Home Health Agency based in Saint Louis, MO. Kenyatta Clark practices in Saint Louis, MO. The NPI Number for Kenyatta Clark is 1922879121 and holds a License No. (Missouri).

The current practice location address for Kenyatta Clark is 4502 Fair Ave, Saint Louis, MO and can be reached out via phone at 314-793-0251.

Location: 4502 Fair Ave, Saint Louis, MO, 63115-3053
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922879121
Provider Name
Kenyatta Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
4502 Fair Ave, Saint Louis, MO, 63115-3053
Phone Number
314-793-0251
Fax Number
Provider Enumeration Date
01/16/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4502 Fair Ave
City
Saint Louis
State
Missouri
Zip
63115-3053
Phone Number
314-793-0251
Fax Number
person
Provider Business Mailing Address Details
Address
4502 Fair Ave
City
Saint Louis
State
Missouri
Zip
63115-3053
Phone Number
314-793-0251
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
251E00000X
License No.
()
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
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