Healthcare Provider Details

I. General information

NPI: 1386159309
Provider Name (Legal Business Name): GERIATRIC CARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2017
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 LILLIAN DR
SAINT CHARLES MO
63304-7032
US

IV. Provider business mailing address

35 LILLIAN DR
SAINT CHARLES MO
63304-7032
US

V. Phone/Fax

Practice location:
  • Phone: 636-939-3833
  • Fax: 636-939-3833
Mailing address:
  • Phone: 636-939-3833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number044623
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MARY J JACKSON
Title or Position: CFO
Credential:
Phone: 636-939-3833