Healthcare Provider Details

I. General information

NPI: 1588287916
Provider Name (Legal Business Name): ST. LOUIS HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7961 BIG BEND BLVD
SAINT LOUIS MO
63119-2703
US

IV. Provider business mailing address

7961 BIG BEND BLVD
SAINT LOUIS MO
63119-2703
US

V. Phone/Fax

Practice location:
  • Phone: 314-962-5700
  • Fax:
Mailing address:
  • Phone: 314-962-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: ERIC SCHMELTEKOPF
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 254-644-0515