Healthcare Provider Details

I. General information

NPI: 1073079091
Provider Name (Legal Business Name): HOMES THAT CARE CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4144 LINDELL BLVD STE 312
SAINT LOUIS MO
63108-2953
US

IV. Provider business mailing address

4144 LINDELL BLVD STE 312
SAINT LOUIS MO
63108-2953
US

V. Phone/Fax

Practice location:
  • Phone: 314-361-2178
  • Fax:
Mailing address:
  • Phone: 314-361-2178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: JOYCE N DAVIS
Title or Position: OWNER/ DIRECTOR
Credential:
Phone: 314-361-2178