Healthcare Provider Details

I. General information

NPI: 1467951459
Provider Name (Legal Business Name): BEYOND HOPE HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7229 PASADENA BLVD
ST. LOUIS MO
63121-2914
US

IV. Provider business mailing address

7229 PASADENA BLVD
ST. LOUIS MO
63121-2914
US

V. Phone/Fax

Practice location:
  • Phone: 314-459-0626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DENISE L NETTLES
Title or Position: MANAGER
Credential:
Phone: 314-459-0626