Healthcare Provider Details

I. General information

NPI: 1134708282
Provider Name (Legal Business Name): ENDEARING HOME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7008 MILBURN ESTATES DR
O FALLON IL
62269-6998
US

IV. Provider business mailing address

7008 MILBURN ESTATES DR
O FALLON IL
62269-6998
US

V. Phone/Fax

Practice location:
  • Phone: 618-670-8558
  • Fax:
Mailing address:
  • Phone: 618-670-8558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER AUSTIN
Title or Position: OWNER
Credential:
Phone: 618-799-7314