Healthcare Provider Details

I. General information

NPI: 1992035810
Provider Name (Legal Business Name): ABSOLUTE HOME CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2009
Last Update Date: 12/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 CHAMBERS
ST. LOUIS MO
63137
US

IV. Provider business mailing address

1175 CHAMBERS RD
SAINT LOUIS MO
63137-1919
US

V. Phone/Fax

Practice location:
  • Phone: 314-732-5285
  • Fax: 314-222-8073
Mailing address:
  • Phone:
  • Fax:

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:

VIII. Authorized Official

Name: KAWANDA REID
Title or Position: DIRECTOR
Credential:
Phone: 314-732-5285