Healthcare Provider Details
I. General information
NPI: 1568975423
Provider Name (Legal Business Name): PREFERRED TOUCH HEALTHCARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/13/2017
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
967 GARDENVIEW OFFICE PKWY STE 16
SAINT LOUIS MO
63141-5917
US
IV. Provider business mailing address
128 BRUSHY BROOK DR
O FALLON MO
63366-4970
US
V. Phone/Fax
- Phone: 314-467-8311
- Fax:
- Phone: 314-467-8311
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICHOLE
SANFORD
Title or Position: DIRECTOR
Credential:
Phone: 314-467-8311