Healthcare Provider Details

I. General information

NPI: 1255849816
Provider Name (Legal Business Name): TRUE BENEVOLENCE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 01/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 BONHOMME AVE
SAINT LOUIS MO
63105-1911
US

IV. Provider business mailing address

7777 BONHOMME AVE
SAINT LOUIS MO
63105-1911
US

V. Phone/Fax

Practice location:
  • Phone: 618-334-7590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: CALVINA MORRIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 618-334-7590