Healthcare Provider Details

I. General information

NPI: 1982806840
Provider Name (Legal Business Name): HOME HEALTH CARE SERVICES OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9953 LEWIS & CLARK BLVD. STE. 106
ST. LOUIS MO
63136
US

IV. Provider business mailing address

9953 LEWIS & CLARK BLVD. STE. 106
ST. LOUIS MO
63136
US

V. Phone/Fax

Practice location:
  • Phone: 314-868-4888
  • Fax: 314-868-2291
Mailing address:
  • Phone: 314-868-4888
  • Fax: 314-868-2291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier286830807
Identifier TypeMEDICAID
Identifier StateMO
Identifier Issuer

VIII. Authorized Official

Name: SANDRA YVONNE GARDNER
Title or Position: ADMINISTRATOR
Credential:
Phone: 314-868-4888