Healthcare Provider Details

I. General information

NPI: 1508789314
Provider Name (Legal Business Name): EMPOWERED CHOICE HOME & COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 DUFFY CT
SAINT PETERS MO
63376-4650
US

IV. Provider business mailing address

18 DUFFY CT
SAINT PETERS MO
63376-4650
US

V. Phone/Fax

Practice location:
  • Phone: 314-882-9170
  • Fax:
Mailing address:
  • Phone: 314-882-9170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CASSIE DEONNE GREEN
Title or Position: MANAGING MEMBER
Credential:
Phone: 314-882-9170