Healthcare Provider Details

I. General information

NPI: 1841864683
Provider Name (Legal Business Name): EXCEPTIONAL QUALITY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 05/17/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4144 LINDELL BLVD STE 411
SAINT LOUIS MO
63108-2954
US

IV. Provider business mailing address

4144 LINDELL BLVD STE 411
SAINT LOUIS MO
63108-2954
US

V. Phone/Fax

Practice location:
  • Phone: 314-484-3260
  • Fax:
Mailing address:
  • Phone: 314-484-3260
  • 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: SHAMIA CARTER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 314-484-3260