MEDICARE: HART TO HART IN HOME HEALTHCARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	372500000X	Chore Provider
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1801389325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HART TO HART IN HOME HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	1408 N KINGSHIGHWAY BLVD STE 104
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-1400
Country	:	US
Telephone Number	:	314-312-0428
Fax Number	:	314-736-0879

Provider Business Practice Location Address
First Line	:	1408 N KINGSHIGHWAY BLVD STE 104
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-1400
Country	:	US
Telephone Number	:	314-312-0428
Fax Number	:	314-736-0879

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KRISIE CATRICE AIKENS
Credential	:
Telephone Number	:	314-312-0428

Provider Enumeration Date	:	06/09/2018
Last Update Date	:	04/24/2020

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