MEDICARE: HOMETEAM TRANSISTION MANAGEMENT GROUP, 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	ERS10407160	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669499570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMETEAM TRANSISTION MANAGEMENT GROUP, LLC

Provider Business Mailing Address
First Line	:	301 SOVEREIGN CT STE 209
Second Line	:
City	:	BALLWIN
State	:	MO
Zip	:	63011-4435
Country	:	US
Telephone Number	:	314-993-4663
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 SOVEREIGN CT STE 209
Second Line	:
City	:	BALLWIN
State	:	MO
Zip	:	63011-4435
Country	:	US
Telephone Number	:	314-993-4663
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	YOSEF MANNE
Credential	:
Telephone Number	:	314-993-4663

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	08/29/2022

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