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General NPI Number Information
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NPI Number | 1942865183
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Entity Type | Organization
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Legal Business Name | SUPPORTIVE CARE SERVICES, LLC
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1100 ROCK CRK ELEM SCHL DR
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City | O FALLON
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State | MO
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Zip | 63366-7577
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Country | US
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Telephone | 636-379-9955
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 ROCK CRK ELEM SCHL DR
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City | O FALLON
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State | MO
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Zip | 63366-7577
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KIRSTEN PAHDE
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Credential |
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Telephone | 636-379-9955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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