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LIVING WATERS CDS, LLC
NPI 1518408939
Home Health in Black Jack, MO

Active since March 17, 2017
12632 BROADRIDGE LN, BLACK JACK, MO 63033(314) 540-5238 Get Directions Write a Review

NPPES record last updated: March 17, 2017. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Living Waters Cds, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIVING WATERS CDS, LLC (NPI 1518408939) is a healthcare organization registered as a home health in Black Jack, Missouri and active in the NPI registry since March 2017. The organization lists Alvia J Carroll, Owner/manager, as its authorized official.

NPPES Registry Identity

NPI1518408939
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameLIVING WATERS CDS, LLC
Location Address12632 BROADRIDGE LNBlack Jack, MO 63033-4604
Mailing Address12632 Broadridge LnBlack Jack, MO 63033-4604
Phone(314) 540-5238
Organization SubpartNo
Authorized OfficialAlvia J CarrollOwner/manager · (314) 540-5238
Enumeration DateMarch 17, 2017
✔ NPI 1518408939 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
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.
12632 BROADRIDGE LN, Black Jack, MO 63033
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALVIA J CARROLL
Home Health Aide
12632 BROADRIDGE LN
BLACK JACK, MO 63033
St. Louis County (314) 540-5238

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Living Waters Cds, LLC's NPI number?

The NPI number for Living Waters Cds, LLC is 1518408939. It was assigned to this organization in the NPPES registry on March 17, 2017.

Where is Living Waters Cds, LLC located?

Living Waters Cds, LLC is located at 12632 Broadridge Ln, Black Jack, MO 63033. The listed phone number is (314) 540-5238.

What is Living Waters Cds, LLC's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

When was this NPI record last updated?

The NPPES record for Living Waters Cds, LLC was last updated on March 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.