MEDICARE: ELISE HOME HEALTH 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	:	1972216158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELISE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	5333 OLENE DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-1417
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5333 OLENE DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-1417
Country	:	US
Telephone Number	:	314-396-0137
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RHONDA ALEXANDER
Credential	:
Telephone Number	:	314-396-0137

Provider Enumeration Date	:	01/03/2023
Last Update Date	:	01/24/2023

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Directions to “ELISE HOME HEALTH LLC ” Practice Location

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