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General NPI Number Information
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NPI Number | 1821207358
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Entity Type | Organization
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Legal Business Name | THE HOME TEAM HOME HEALTH SERVICES & ADULT DAYCARE LLC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 6407 MICHIGAN AVE OFC
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City | SAINT LOUIS
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State | MO
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Zip | 63111-2802
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Country | US
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Telephone | 314-922-3208
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Fax | 314-448-1891
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Provider Business Mailing Address
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Address Line | 6600 PENNSYLVANIA AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63111-2903
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Country | US
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Telephone | 314-922-3208
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Fax | 314-448-1891
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. SPARKS ANDERSON STONE
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Credential | EMT-P
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Telephone | 314-922-3208
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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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