MEDICARE: ADVANCED COMFORT HEALTH SOLUTIONS 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	:	1811314230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED COMFORT HEALTH SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1913 CONGRESS ST STE B
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-1705
Country	:	US
Telephone Number	:	314-373-0462
Fax Number	:

Provider Business Practice Location Address
First Line	:	1913 CONGRESS ST STE B
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-1705
Country	:	US
Telephone Number	:	314-373-0462
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TANISHA C HARRELL
Credential	:
Telephone Number	:	314-373-0462

Provider Enumeration Date	:	03/24/2014
Last Update Date	:	03/24/2014

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