Healthcare Provider Details

I. General information

NPI: 1922481563
Provider Name (Legal Business Name): HEALTHCARE R US ACCESSIBLE LIVING SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2859 SIDNEY ST
SAINT LOUIS MO
63104-2332
US

IV. Provider business mailing address

2859 SIDNEY ST
SAINT LOUIS MO
63104-2332
US

V. Phone/Fax

Practice location:
  • Phone: 314-699-3548
  • Fax:
Mailing address:
  • Phone: 314-699-3548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: KALEN HODEST
Title or Position: DIRECTOR
Credential:
Phone: 314-699-3548