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General NPI Number Information
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NPI Number | 1083110647
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Entity Type | Organization
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Legal Business Name | SPECIALTY HOME HEALTHCARE INC.
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 2012 WOODSON RD STE D
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City | OVERLAND
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State | MO
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Zip | 63114-5644
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Country | US
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Telephone | 314-222-9521
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Fax | 636-220-8379
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Provider Business Mailing Address
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Address Line | PO BOX 410181
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City | CREVE COEUR
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State | MO
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Zip | 63141-0181
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Country | US
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Telephone | 314-712-6170
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Fax |
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | LONNIKAH HOLMES
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Credential |
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Telephone | 314-368-4207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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