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NPI Code Detail

MEDICARE: YOUR WAY HOMECARE LLC

MEDICARE: YOUR WAY HOMECARE 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1679137749
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUR WAY HOMECARE LLC
Provider Business Mailing Address
First Line : 111 W PORT PLZ STE 600
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-3015
Country : US
Telephone Number : 636-329-4490
Fax Number :
Provider Business Practice Location Address
First Line : 111 W PORT PLZ STE 600
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-3015
Country : US
Telephone Number : 636-329-4490
Fax Number :
Authorized Official
Title or Position : FOUNDER
Name : MISS PRECIOUS GRAHAM
Credential :
Telephone Number : 213-808-7015
Provider Enumeration Date : 04/24/2019
Last Update Date : 04/24/2019

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Directions to “YOUR WAY HOMECARE LLC ” Practice Location

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