=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598112971
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A HEART FULL OF LOVE IN HOME HEALTH CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2016
-----------------------------------------------------
Last Update Date | 12/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2025 5TH BRENTWOOD 201-2
-----------------------------------------------------
City | BRENTWOOD
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-643-9225
-----------------------------------------------------
Fax | 314-480-6179
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2025 5TH BRENTWOOD 201-2
-----------------------------------------------------
City | BRENTWOOD
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-269-6907
-----------------------------------------------------
Fax | 314-480-6179
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LISA L GREGORY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 314-269-6907
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 372500000X
-----------------------------------------------------
Taxonomy Name | Chore Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------