MEDICARE: GERIATRIC CARE SOLUTIONS

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	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency
3	310400000X	Assisted Living Facility	044623	MO

General Provider Information

NPI Number	:	1386159309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERIATRIC CARE SOLUTIONS

Provider Business Mailing Address
First Line	:	35 LILLIAN DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63304-7032
Country	:	US
Telephone Number	:	636-939-3833
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 LILLIAN DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63304-7032
Country	:	US
Telephone Number	:	636-939-3833
Fax Number	:	636-939-3833

Authorized Official
Title or Position	:	CFO
Name	:	MARY J JACKSON
Credential	:
Telephone Number	:	636-939-3833

Provider Enumeration Date	:	12/13/2017
Last Update Date	:	09/27/2019

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