Healthcare Provider Details

I. General information

NPI: 1407370521
Provider Name (Legal Business Name): AT YOUR CARE HOME SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 07/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 TUXFORD DR
SAINT LOUIS MO
63146-5825
US

IV. Provider business mailing address

10315 TUXFORD DR
SAINT LOUIS MO
63146-5825
US

V. Phone/Fax

Practice location:
  • Phone: 314-942-8098
  • 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
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LEEANDRE RATLIFF
Title or Position: OWNER/MANAGER
Credential:
Phone: 314-942-8098