MEDICARE: COOL'S CARE WITH HEART, HOME HEALTHCARE LLC

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

General Provider Information

NPI Number	:	1467308239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COOL'S CARE WITH HEART, HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	321 ASPEN CREEK DR
Second Line	:
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-5579
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 ASPEN CREEK DR
Second Line	:
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-5579
Country	:	US
Telephone Number	:	636-378-4826
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALIYAH CLARK
Credential	:
Telephone Number	:	636-515-9710

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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