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General NPI Number Information
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NPI Number | 1861145914
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Entity Type | Organization
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Legal Business Name | ACCREDITED HOME CARE
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Dates
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Enumeration Date | 01/29/2022
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 2055 CRAIGSHIRE RD STE 410C
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City | SAINT LOUIS
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State | MO
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Zip | 63146-4036
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Country | US
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Telephone | 314-359-3630
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Fax | 314-485-1336
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Provider Business Mailing Address
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Address Line | 910 LILAC DR
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City | FLORISSANT
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State | MO
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Zip | 63031-3124
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Country | US
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Telephone | 314-392-1150
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LATRICE WESLEY
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Credential |
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Telephone | 314-392-1150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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