Healthcare Provider Details

I. General information

NPI: 1700770716
Provider Name (Legal Business Name): UNITED AT HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 S 6TH ST STE N
LAS VEGAS NV
89101-6948
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: 314-944-9008
Mailing address:
  • Phone: 314-919-5214
  • Fax: 314-944-9008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

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