Healthcare Provider Details

I. General information

NPI: 1588815153
Provider Name (Legal Business Name): PARAQUAD IN-HOME SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5240 OAKLAND AVE
SAINT LOUIS MO
63110-1436
US

IV. Provider business mailing address

5240 OAKLAND AVE
SAINT LOUIS MO
63110-1436
US

V. Phone/Fax

Practice location:
  • Phone: 314-289-4200
  • Fax: 314-289-4201
Mailing address:
  • Phone: 314-289-4200
  • Fax: 314-289-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT FUNK
Title or Position: CEO
Credential:
Phone: 314-289-4200