Healthcare Provider Details

I. General information

NPI: 1639146707
Provider Name (Legal Business Name): CARING HEARTS AGENCY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8944 NATURAL BRIDGE RD
SAINT LOUIS MO
63121-3917
US

IV. Provider business mailing address

8944 NATURAL BRIDGE RD
SAINT LOUIS MO
63121-3917
US

V. Phone/Fax

Practice location:
  • Phone: 314-426-1901
  • Fax: 314-426-1830
Mailing address:
  • Phone: 314-426-1901
  • Fax: 314-426-1830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number6697
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY J HICKMON
Title or Position: ADMINISTRATOR/CEO
Credential: R.N., B.S.N., N.P.
Phone: 314-426-1901