Healthcare Provider Details

I. General information

NPI: 1427888726
Provider Name (Legal Business Name): 1ST FRUITS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 CARONDELET AVE STE 505
CLAYTON MO
63105-3323
US

IV. Provider business mailing address

7710 CARONDELET AVE STE 505
CLAYTON MO
63105-3323
US

V. Phone/Fax

Practice location:
  • Phone: 557-214-9190
  • Fax: 314-334-1010
Mailing address:
  • Phone: 557-214-9190
  • Fax: 314-334-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALISIA GREER
Title or Position: ADMIN
Credential:
Phone: 557-214-9190