=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811194889
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE POINT OF CHANGE NURSING SERVICE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4335 LEXINGTON AVE
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63115-2845
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-533-1200
-----------------------------------------------------
Fax | 314-533-1202
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4335 LEXINGTON AVE
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63115-2845
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-533-1200
-----------------------------------------------------
Fax | 314-533-1202
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. NORMA JEAN BROOKS
-----------------------------------------------------
Credential | REGISTERED NURSE
-----------------------------------------------------
Telephone | 314-533-1200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | LC6712410
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------