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General NPI Number Information
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NPI Number | 1922646728
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Entity Type | Organization
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Legal Business Name | EDUHEALTH PERSONAL CARE SERVICES
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 5843 EAGLE VALLEY DR SAINT LOUIS MO 63136
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City | SAINT LOUIS
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State | MO
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Zip | 63136
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Country | US
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Telephone | 314-371-7717
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Fax |
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Provider Business Mailing Address
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Address Line | 5843 EAGLE VALLEY DR SAINT LOUIS MO 63136
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City | SAINT LOUIS
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State | MO
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Zip | 63136
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Country | US
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Telephone | 314-371-7717
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TINNYAH BRANDON
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Credential |
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Telephone | 314-371-7717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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