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General NPI Number Information
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NPI Number | 1346664703
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Entity Type | Organization
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Legal Business Name | FAMILY UNITED HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 12592 COUNTRYBROOK DR
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City | SAINT LOUIS
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State | MO
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Zip | 63138-2704
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Country | US
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Telephone | 314-716-3100
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Fax | 314-942-9998
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Provider Business Mailing Address
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Address Line | 12592 COUNTRYBROOK DR
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City | SAINT LOUIS
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State | MO
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Zip | 63138
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Country | US
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Telephone | 314-716-3100
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Fax | 314-942-9998
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MARLOS REYNOLDS
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Credential |
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Telephone | 314-220-8781
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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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