Healthcare Provider Details

I. General information

NPI: 1326311184
Provider Name (Legal Business Name): COMPREHENSIVE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 02/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 HIGH ST SUITE 203
WASHINGTON MO
63090-6490
US

IV. Provider business mailing address

1749 GILSINN LN
FENTON MO
63026-2008
US

V. Phone/Fax

Practice location:
  • Phone: 636-390-9510
  • Fax: 636-390-8992
Mailing address:
  • Phone: 636-349-2311
  • Fax: 636-349-6491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number746-8HH
License Number StateMO

VIII. Authorized Official

Name: GREG SPENCE
Title or Position: OWNER
Credential:
Phone: 636-349-2311