Healthcare Provider Details

I. General information

NPI: 1033943360
Provider Name (Legal Business Name): SAINT LOUIS HOMECARE AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12166 OLD BIG BEND RD STE 310
KIRKWOOD MO
63122-6836
US

IV. Provider business mailing address

6389 HIGHWAY C
PALMYRA MO
63461-2044
US

V. Phone/Fax

Practice location:
  • Phone: 314-835-1100
  • Fax:
Mailing address:
  • Phone: 217-242-7718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RYAN W MORRIS
Title or Position: PRESIDENT
Credential:
Phone: 217-242-7718