MEDICARE: HUMANITY HEALTHCARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1386304384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMANITY HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	3660 FINNEY AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-3902
Country	:	US
Telephone Number	:	314-393-3616
Fax Number	:

Provider Business Practice Location Address
First Line	:	1708 DELMAR BLVD STE 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-1710
Country	:	US
Telephone Number	:	314-393-3616
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LARHONDA STARKS
Credential	:
Telephone Number	:	314-393-3616

Provider Enumeration Date	:	12/19/2021
Last Update Date	:	12/19/2021

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