Healthcare Provider Details

I. General information

NPI: 1366384299
Provider Name (Legal Business Name): PERSONAL HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4884 BROOKE HILL CT
LIBERTY TWP OH
45011-0418
US

IV. Provider business mailing address

4884 BROOKE HILL CT
LIBERTY TWP OH
45011-0418
US

V. Phone/Fax

Practice location:
  • Phone: 314-899-3904
  • Fax:
Mailing address:
  • Phone: 314-899-3904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: YOLANDA SMITH
Title or Position: DIRECTOR
Credential: SMITH
Phone: 314-899-3904