Healthcare Provider Details

I. General information

NPI: 1386160570
Provider Name (Legal Business Name): MYCARE IN-HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2521 WOODSON RD
SAINT LOUIS MO
63114-5436
US

IV. Provider business mailing address

2521 WOODSON RD
SAINT LOUIS MO
63114-5436
US

V. Phone/Fax

Practice location:
  • Phone: 800-486-8053
  • Fax:
Mailing address:
  • Phone: 800-486-8053
  • Fax: 314-548-9455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS RACHELLE L PAYNE
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 800-486-8053