Bread of Life CDS LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BREAD OF LIFE CDS LLC

Practice address

3029 Saint Vincent Ave
Saint Louis, MO 63104-1421

Phone

(314) 874-9616

Fax

(314) 000-0000

NPI assigned

Mar 7, 2017

Organization subpart

No

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

Authorized official

Name

Delores Bingham

Title

Director

Phone

(314) 874-9616

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1396285433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3029 SAINT VINCENT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041421",
            "telephone_number": "314-874-9616",
            "fax_number": "314-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3029 SAINT VINCENT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041421",
            "telephone_number": "314-874-9616",
            "fax_number": "314-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAD OF LIFE CDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "BINGHAM",
        "authorized_official_first_name": "DELORES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-874-9616"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251E00000X",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Lynn Bray
• Melba L Bray, CRNA
• Kristina Brazier, D.C.
• Lisa Marie Brazil, LCSW
• Lauren Noelle Brazzell, PHARM.D.
• Bread of Life Healthcare
• Angie Breakfield, P.T.
• Jerry Breakstone, MSW, LCSW
• Breakthrough Healthcare Limited Liability Company
• Breakthrough Healthcare Limited Liability Company

• Home Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.