Healthcare Provider Details

I. General information

NPI: 1336769876
Provider Name (Legal Business Name): BEAM HOME HEALTHCARE AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 S OLD HIGHWAY 94 STE 104
SAINT CHARLES MO
63304-2834
US

IV. Provider business mailing address

3910 S OLD HIGHWAY 94 STE 104
SAINT CHARLES MO
63304-2834
US

V. Phone/Fax

Practice location:
  • Phone: 314-699-0757
  • Fax:
Mailing address:
  • Phone: 314-699-0757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ASHLEY HUSTON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 314-699-0757