Healthcare Provider Details

I. General information

NPI: 1295443042
Provider Name (Legal Business Name): PASSIONATE HELPING HANDS RESIDENTIAL CARE FACILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 11/10/2022
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 PEACH HILL LN APT 201
CHESTERFIELD MO
63017-2089
US

IV. Provider business mailing address

229 ROLAND AVE
BALLWIN MO
63021-5237
US

V. Phone/Fax

Practice location:
  • Phone: 314-703-1608
  • Fax:
Mailing address:
  • Phone: 314-287-1266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VERONICA D HAMILTON
Title or Position: OWNER
Credential: CNA
Phone: 314-703-1608