Humble Abode Residence

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

HUMBLE ABODE RESIDENCE

Practice address

18 S Duchesne Dr
Florissant, MO 63031-8112

Phone

(314) 898-2165

NPI assigned

Oct 9, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Deangela Edwards

Title

Executive Director

Phone

(314) 898-2165

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1144862350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 S DUCHESNE DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318112",
            "telephone_number": "314-898-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 S DUCHESNE DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318112",
            "telephone_number": "314-898-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBLE ABODE RESIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DEANGELA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "314-898-2165"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Otis Thomas Hudson II, BA
• Paige Elizabeth Huette, FNP
• Deana Huff
• Kenneth Charles Hughes
• Alicia Hughley
• Humble Haven Care Services, LLC (Humble Haven Care Services)
• Stacey Nicole Humphrey
• Jared Hunt
• Marla Bonita Hunt, CNA
• Veronica Huntley

• Assisted Living Facility (Mental Illness) in Florissant, MO
• Providers in Florissant, MO by specialty
• Assisted Living Facility (Mental Illness) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.