Healthcare Provider Details

I. General information

NPI: 1053669689
Provider Name (Legal Business Name): HOMEPOINTE HEALTHCARE OF MISSOURI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 FERN RIDGE PKWY STE 107
SAINT LOUIS MO
63141-4401
US

IV. Provider business mailing address

8515 BLUFFTON RD
FORT WAYNE IN
46809-3022
US

V. Phone/Fax

Practice location:
  • Phone: 877-744-6145
  • Fax: 260-444-0006
Mailing address:
  • Phone: 260-744-6145
  • Fax: 260-444-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM J SWISS
Title or Position: PRESIDENT
Credential:
Phone: 260-744-6145