Healthcare Provider Details

I. General information

NPI: 1245636109
Provider Name (Legal Business Name): OH SO GOOD HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11116 S TOWNE SQ SUITE 104
SAINT LOUIS MO
63123-7809
US

IV. Provider business mailing address

923 IRON ST
SAINT LOUIS MO
63111-2645
US

V. Phone/Fax

Practice location:
  • Phone: 314-436-9941
  • Fax: 314-932-5696
Mailing address:
  • Phone: 314-341-5481
  • Fax: 314-932-5696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LASHONDA Q LEWIS
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 314-341-5481