MEDICARE: ATTENTIVE HOME 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1629513551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATTENTIVE HOME CARE LLC

Provider Business Mailing Address
First Line	:	8021 WAYLAND CT
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-4603
Country	:	US
Telephone Number	:	314-585-2836
Fax Number	:	314-428-1406

Provider Business Practice Location Address
First Line	:	8021 WAYLAND CT
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-4603
Country	:	US
Telephone Number	:	314-585-2836
Fax Number	:	314-428-1406

Authorized Official
Title or Position	:	MANGER
Name	:	SHAWANDA ABERNATHY
Credential	:
Telephone Number	:	314-585-2836

Provider Enumeration Date	:	01/02/2017
Last Update Date	:	01/02/2017

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Directions to “ATTENTIVE HOME CARE LLC ” Practice Location

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