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General NPI Number Information
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NPI Number | 1235637422
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Entity Type | Organization
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Legal Business Name | NEW SEASON HOME HEALTH IN HOME LLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 11520 SAINT CHARLES ROCK RD STE 102A
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City | BRIDGETON
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State | MO
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Zip | 63044-2732
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Country | US
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Telephone | 314-287-3628
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Fax | 314-778-3456
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Provider Business Mailing Address
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Address Line | 3486A HOLLENBERG DR
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City | BRIDGETON
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State | MO
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Zip | 63044-2429
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Country | US
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Telephone | 314-287-3628
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Fax | 314-778-3456
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Authorized Official
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Title or Position | DESIGNATED MANAGER
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Name | MRS. CAROLYN ROCHELLE SHERRARD
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Credential |
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Telephone | 314-699-5607
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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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