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General NPI Number Information
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NPI Number | 1366412702
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Entity Type | Organization
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Legal Business Name | PT HOME SERVICES OF MO, INC.
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 141 N MERAMEC AVE #317
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City | CLAYTON
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State | MO
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Zip | 63105-3750
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Country | US
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Telephone | 314-727-0229
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Fax | 314-727-3667
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Provider Business Mailing Address
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Address Line | 22215 NORTHERN BLVD
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City | BAYSIDE
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State | NY
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Zip | 11361-3603
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Country | US
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Telephone | 718-468-4747
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Fax | 718-264-5834
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Authorized Official
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Title or Position | CONTRACT MANAGER
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Name | LORIGAY LASKIN
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Credential |
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Telephone | 718-468-4747
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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 | 3821
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License Number State | MO
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