MEDICARE: URSULAS 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1730812256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URSULAS HOME CARE LLC

Provider Business Mailing Address
First Line	:	6911 IRA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-3403
Country	:	US
Telephone Number	:	314-319-7134
Fax Number	:

Provider Business Practice Location Address
First Line	:	6911 IRA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-3403
Country	:	US
Telephone Number	:	314-319-7134
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CATHERINE HARVEY-COTTON
Credential	:
Telephone Number	:	314-319-7134

Provider Enumeration Date	:	07/01/2022
Last Update Date	:	07/01/2022

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Directions to “URSULAS HOME CARE LLC ” Practice Location

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