Healthcare Provider Details

I. General information

NPI: 1538376306
Provider Name (Legal Business Name): MISSOURI PROFESSIONAL STAFFING SERVICE HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 CRAIG RD SUITE 201
CREVE COEUR MO
63141-7120
US

IV. Provider business mailing address

680 CRAIG RD SUITE 201
CREVE COEUR MO
63141-7120
US

V. Phone/Fax

Practice location:
  • Phone: 314-567-0073
  • Fax: 314-567-1940
Mailing address:
  • Phone: 314-567-0073
  • Fax: 314-567-1940

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: MRS. JANE CAROL HILTON
Title or Position: PRESIDENT
Credential: RN
Phone: 314-567-0073