Healthcare Provider Details

I. General information

NPI: 1447807847
Provider Name (Legal Business Name): ENDEARMENT HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S 4TH ST STE 550
SAINT LOUIS MO
63102-1897
US

IV. Provider business mailing address

100 S 4TH ST STE 550
SAINT LOUIS MO
63102-1897
US

V. Phone/Fax

Practice location:
  • Phone: 314-598-8813
  • Fax: 314-546-4488
Mailing address:
  • Phone: 314-598-8813
  • Fax: 314-546-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SHEENA N JEFFERSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 314-598-8813