Healthcare Provider Details

I. General information

NPI: 1841338068
Provider Name (Legal Business Name): LYNN IN-HOME HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12912 NEW HALLS FERRY RD
FLORISSANT MO
63033-4035
US

IV. Provider business mailing address

12912 NEW HALLS FERRY RD
FLORISSANT MO
63033-4035
US

V. Phone/Fax

Practice location:
  • Phone: 314-837-1660
  • Fax: 314-837-3447
Mailing address:
  • Phone: 314-837-1660
  • Fax: 314-837-3447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number8705369
License Number StateMO

VIII. Authorized Official

Name: MRS. JACQUELYN MARIE HUTSON
Title or Position: DIRECTOR
Credential: RN
Phone: 314-837-1660