Healthcare Provider Details

I. General information

NPI: 1154534774
Provider Name (Legal Business Name): PERSONAL TOUCH HOME CARE OF MO, INC,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 NORTH MERAMAC #317
CLAYTON MO
63105
US

IV. Provider business mailing address

222-15 NORTHERN BLVD.
BAYSIDE NY
11361
US

V. Phone/Fax

Practice location:
  • Phone: 314-727-0229
  • Fax: 314-727-3667
Mailing address:
  • Phone: 718-468-4747
  • Fax: 718-264-5834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number38-23HH
License Number StateMO

VIII. Authorized Official

Name: LORIGAY LASKIN
Title or Position: CONTRACT MANAGER
Credential:
Phone: 718-468-4747