Healthcare Provider Details

I. General information

NPI: 1558856831
Provider Name (Legal Business Name): LEA HELEN'S HELPING HANDS FOR SUPPORTIVE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 02/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9717 LANDMARK PARKWAY DR STE 115
SAINT LOUIS MO
63127-1662
US

IV. Provider business mailing address

9717 LANDMARK PARKWAY DR STE 115
SAINT LOUIS MO
63127-1662
US

V. Phone/Fax

Practice location:
  • Phone: 314-722-6555
  • Fax: 314-722-6551
Mailing address:
  • Phone: 314-222-0711
  • Fax: 314-722-6551

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: SECIL A SCHODROSKI
Title or Position: OWNER/FNP-C/DNP
Credential: FNP-C,DNP
Phone: 314-222-0711