Healthcare Provider Details
I. General information
NPI: 1255867024
Provider Name (Legal Business Name): GIVING HOUSE OF LIFE HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2017
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1515 N WARSON RD STE 297
SAINT LOUIS MO
63132-1110
US
IV. Provider business mailing address
1991 SHOREHAM DR
FLORISSANT MO
63033-1235
US
V. Phone/Fax
- Phone: 314-665-9134
- Fax: 314-985-5899
- Phone: 314-665-9134
- Fax: 773-496-7068
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
EBONY
S
WASHINGTON
Title or Position: OWNER/CEO/PRESIDENT
Credential:
Phone: 314-665-9134