Healthcare Provider Details

I. General information

NPI: 1477929131
Provider Name (Legal Business Name): LINCOLN'S HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2015
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3718 HOFFMEISTER AVE
SAINT LOUIS MO
63125-1424
US

IV. Provider business mailing address

3718 HOFFMEISTER AVE
SAINT LOUIS MO
63125-1424
US

V. Phone/Fax

Practice location:
  • Phone: 314-202-0222
  • 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

VIII. Authorized Official

Name: LINCOLN PARKER
Title or Position: OWNER
Credential:
Phone: 314-600-7671