Healthcare Provider Details

I. General information

NPI: 1922470657
Provider Name (Legal Business Name): RELIABLE HOME HEALTH CDS SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2804 BROWN RD
SAINT LOUIS MO
63114-4906
US

IV. Provider business mailing address

2804 BROWN RD
SAINT LOUIS MO
63114-4906
US

V. Phone/Fax

Practice location:
  • Phone: 314-427-2650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SHARON SMITH
Title or Position: DIRECTOR
Credential:
Phone: 314-427-2650