MEDICARE: A DIMENSION OF IN HOME CARE

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1366954299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A DIMENSION OF IN HOME CARE

Provider Business Mailing Address
First Line	:	1911 WASHINGTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-1623
Country	:	US
Telephone Number	:	314-322-9429
Fax Number	:

Provider Business Practice Location Address
First Line	:	1911 WASHINGTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-1623
Country	:	US
Telephone Number	:	314-322-9429
Fax Number	:

Authorized Official
Title or Position	:	DESIGNATED MANAGER
Name	:	VALERIE SMITH
Credential	:	BA
Telephone Number	:	314-374-4487

Provider Enumeration Date	:	11/01/2017
Last Update Date	:	11/01/2017

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Directions to “A DIMENSION OF IN HOME CARE ” Practice Location

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