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General NPI Number Information
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NPI Number | 1427701838
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Entity Type | Organization
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Legal Business Name | EXCELLENT HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 100 SOUTH 4TH STREET STE 550
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City | SAINT LOUIS
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State | MO
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Zip | 63102
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Country | US
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Telephone | 314-857-5339
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Fax | 314-769-9859
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Provider Business Mailing Address
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Address Line | 100 SOUTH 4TH STREET STE 550
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City | SAINT LOUIS
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State | MO
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Zip | 63102
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Country | US
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Telephone | 314-857-5339
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Fax | 314-769-9859
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Authorized Official
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Title or Position | OWNER
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Name | MISS MICHELLE GREGORY
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Credential |
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Telephone | 314-437-7549
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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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