Healthcare Provider Details

I. General information

NPI: 1568068120
Provider Name (Legal Business Name): SWB FAMILY HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4144 LINDELL BLVD STE 326
SAINT LOUIS MO
63108-2953
US

IV. Provider business mailing address

4144 LINDELL BLVD STE 326
SAINT LOUIS MO
63108-2953
US

V. Phone/Fax

Practice location:
  • Phone: 314-443-2891
  • Fax: 314-395-9079
Mailing address:
  • Phone: 314-443-2891
  • Fax: 314-395-9079

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: MICHAEL WRIGHT
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 314-443-2891