Healthcare Provider Details

I. General information

NPI: 1265952170
Provider Name (Legal Business Name): A & S LOVING CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 06/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 WASHINGTON AVE SUIT 510
SAINT LOUIS MO
63103
US

IV. Provider business mailing address

1409 WASHINGTON AVE STE 510
SAINT LOUIS MO
63103-1901
US

V. Phone/Fax

Practice location:
  • Phone: 314-256-9242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAKEITA ANDERSON
Title or Position: MANAGER
Credential:
Phone: 314-256-9242