MEDICARE: MEMORY CARE HOME SOLUTIONS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker
3	2084N0400X	Neurology Physician
4	225X00000X	Occupational Therapist
5	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1346787421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORY CARE HOME SOLUTIONS

Provider Business Mailing Address
First Line	:	4389 W PINE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2205
Country	:	US
Telephone Number	:	314-645-6247
Fax Number	:	314-645-6249

Provider Business Practice Location Address
First Line	:	4389 W PINE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2205
Country	:	US
Telephone Number	:	314-645-6247
Fax Number	:	314-645-6249

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MS. JILL CIGLIANA
Credential	:	MSOT, OTR/L
Telephone Number	:	314-645-6247

Provider Enumeration Date	:	01/26/2017
Last Update Date	:	02/10/2025

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