Organization Name: | MAYHEM BAR AND GRILL INC |
NPI Number: | 1902264286 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMEE BURKETT (OWNER) |
Mailing Address: | 1740 Leafcrest Dr Hazelwood |
State: | MO US |
Postal Code: | 630421562 |
Phone Number: | 3149208311 |
Fax Number: | 3146663388 |
NPI Enumeration Date: | 02/02/2016 |
NPI Last Update Date: | 02/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |