MEDICARE: UNITED AT HOME

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1700770716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED AT HOME

Provider Business Mailing Address
First Line	:	4670 LANSDOWNE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-1523
Country	:	US
Telephone Number	:	314-919-5214
Fax Number	:	314-944-9008

Provider Business Practice Location Address
First Line	:	732 S 6TH ST STE N
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6948
Country	:	US
Telephone Number	:	314-919-5214
Fax Number	:	314-944-9008

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KHANH BUI
Credential	:
Telephone Number	:	314-919-5214

Provider Enumeration Date	:	06/04/2025
Last Update Date	:	04/08/2026

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Directions to “UNITED AT HOME ” Practice Location

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