MEDICARE: JENN-CARE HOME NURSINGS & SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	060824	MO

General Provider Information

NPI Number	:	1013120096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENN-CARE HOME NURSINGS & SERVICES INC

Provider Business Mailing Address
First Line	:	6104 WYMA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63120-1331
Country	:	US
Telephone Number	:	314-381-0930
Fax Number	:	314-381-1216

Provider Business Practice Location Address
First Line	:	6104 WYMA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63120-1331
Country	:	US
Telephone Number	:	314-381-0930
Fax Number	:	314-381-1216

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. FAIRESTENE JENNINGS
Credential	:
Telephone Number	:	314-381-0930

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	11/29/2007

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