MEDICARE: ACTS OF CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	LC001473531	MO

General Provider Information

NPI Number	:	1043663784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTS OF CARE, LLC

Provider Business Mailing Address
First Line	:	6618 BOLES AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-3202
Country	:	US
Telephone Number	:	314-517-3337
Fax Number	:

Provider Business Practice Location Address
First Line	:	6618 BOLES AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-3202
Country	:	US
Telephone Number	:	314-517-3337
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MIRIAM HARRIS
Credential	:
Telephone Number	:	314-517-3337

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	09/02/2016

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