Healthcare Provider Details

I. General information

NPI: 1598112971
Provider Name (Legal Business Name): A HEART FULL OF LOVE IN HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 5TH BRENTWOOD 201-2
BRENTWOOD MO
63144
US

IV. Provider business mailing address

2025 5TH BRENTWOOD 201-2
BRENTWOOD MO
63144
US

V. Phone/Fax

Practice location:
  • Phone: 314-643-9225
  • Fax: 314-480-6179
Mailing address:
  • Phone: 314-269-6907
  • Fax: 314-480-6179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: LISA L GREGORY
Title or Position: OWNER
Credential:
Phone: 314-269-6907