=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386040657
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HANDS ACROSS ST. LOUIS HOME HEALTHCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2014
-----------------------------------------------------
Last Update Date | 11/13/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4200 UNION BLVD STE#126
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63115-1227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-601-4892
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4200 UNION BLVD STE#126
-----------------------------------------------------
City | ST. LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63137
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | JACQUELINE JONES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 314-601-4892
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------