MEDICARE: SHEA HOME CARE, INC.

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	0010348	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801106927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHEA HOME CARE, INC.

Provider Business Mailing Address
First Line	:	9378 OLIVE BLVD STE 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-3222
Country	:	US
Telephone Number	:	314-872-7749
Fax Number	:

Provider Business Practice Location Address
First Line	:	9378 OLIVE BLVD STE 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-3222
Country	:	US
Telephone Number	:	314-872-7749
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DARLENE SEYER
Credential	:
Telephone Number	:	314-872-7749

Provider Enumeration Date	:	10/08/2010
Last Update Date	:	12/08/2017

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Directions to “SHEA HOME CARE, INC. ” Practice Location

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