Healthcare Provider Details

I. General information

NPI: 1992631139
Provider Name (Legal Business Name): UNITED AT HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 E TROPICANA AVE STE 137
LAS VEGAS NV
89119-6552
US

IV. Provider business mailing address

4670 LANSDOWNE AVE
SAINT LOUIS MO
63116-1523
US

V. Phone/Fax

Practice location:
  • Phone: 314-919-5214
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: KHANH BUI
Title or Position: DIRECTOR
Credential:
Phone: 314-919-5214