Healthcare Provider Details

I. General information

NPI: 1124220504
Provider Name (Legal Business Name): INFINITI HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 PENNSYLVANIA AVE
SAINT LOUIS MO
63133-1035
US

IV. Provider business mailing address

1321 PENNSYLVANIA AVE
SAINT LOUIS MO
63133-1035
US

V. Phone/Fax

Practice location:
  • Phone: 314-496-6536
  • Fax: 314-862-2331
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: LISA BRADLEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 314-496-6536