Healthcare Provider Details

I. General information

NPI: 1831000306
Provider Name (Legal Business Name): AUTISM ALLY PERSONAL CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12412 LUSHER RD
SAINT LOUIS MO
63138-1456
US

IV. Provider business mailing address

12412 LUSHER RD
SAINT LOUIS MO
63138-1456
US

V. Phone/Fax

Practice location:
  • Phone: 877-273-4376
  • Fax: 317-287-3788
Mailing address:
  • Phone: 877-273-4376
  • Fax: 317-287-3788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management 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: SHASMINE SUMMERS
Title or Position: MANAGER
Credential:
Phone: 877-273-4376