Healthcare Provider Details

I. General information

NPI: 1346787421
Provider Name (Legal Business Name): MEMORY CARE HOME SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4389 W PINE BLVD
SAINT LOUIS MO
63108-2205
US

IV. Provider business mailing address

4389 W PINE BLVD
SAINT LOUIS MO
63108-2205
US

V. Phone/Fax

Practice location:
  • Phone: 314-645-6247
  • Fax: 314-645-6249
Mailing address:
  • Phone: 314-645-6247
  • Fax: 314-645-6249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. JILL CIGLIANA
Title or Position: PROGRAM DIRECTOR
Credential: MSOT, OTR/L
Phone: 314-645-6247