Healthcare Provider Details

I. General information

NPI: 1245048107
Provider Name (Legal Business Name): HERE AT HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2024
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16511 WILD HORSE CREEK RD APT 241
CHESTERFIELD MO
63017-1435
US

IV. Provider business mailing address

613 BIG BEND RD STE 1767
MANCHESTER MO
63021-7735
US

V. Phone/Fax

Practice location:
  • Phone: 314-708-8716
  • Fax:
Mailing address:
  • Phone: 314-708-8716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY STIPPEC
Title or Position: CO-OWNER/COO
Credential:
Phone: 314-910-1397