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NPI Code Detail

MEDICARE: SOC IN HOME SERVICES LLC

MEDICARE: SOC IN HOME SERVICES 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1114336146
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOC IN HOME SERVICES LLC
Provider Business Mailing Address
First Line : 1360 S 5TH ST STE 386B
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-2449
Country : US
Telephone Number : 636-493-9688
Fax Number : 636-493-9688
Provider Business Practice Location Address
First Line : 1360 S 5TH ST STE 386B
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-2449
Country : US
Telephone Number : 636-493-9688
Fax Number : 636-493-9688
Authorized Official
Title or Position : DIRECTOR
Name : LASHONDA MORELAND
Credential :
Telephone Number : 314-625-4215
Provider Enumeration Date : 08/04/2014
Last Update Date : 08/04/2014

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Directions to “SOC IN HOME SERVICES LLC ” Practice Location

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