Healthcare Provider Details

I. General information

NPI: 1659408102
Provider Name (Legal Business Name): HOME CARE SERVICES OF METROPOLITAN ST LOUIS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S CENTRAL AVE #108
SAINT LOUIS MO
63105-3517
US

IV. Provider business mailing address

201 S CENTRAL AVE #108
SAINT LOUIS MO
63105-3517
US

V. Phone/Fax

Practice location:
  • Phone: 314-863-1040
  • Fax: 314-863-3257
Mailing address:
  • Phone: 314-863-1040
  • Fax: 314-863-3257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
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 Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: THOMAS LANE
Title or Position: DIRECTOR
Credential:
Phone: 314-863-1040