Healthcare Provider Details

I. General information

NPI: 1245188929
Provider Name (Legal Business Name): HUDUMA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5141 LOTUS AVE
SAINT LOUIS MO
63113-1127
US

IV. Provider business mailing address

5141 LOTUS AVE
SAINT LOUIS MO
63113-1127
US

V. Phone/Fax

Practice location:
  • Phone: 314-536-7507
  • Fax:
Mailing address:
  • Phone: 314-536-7507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHANTEL WOODS
Title or Position: MANAGER
Credential:
Phone: 314-536-7507