MEDICARE: WHOLE HEART CARE SERVICES 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	:	1871308023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLE HEART CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	9268 E BRECKENRIDGE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-4708
Country	:	US
Telephone Number	:	314-405-1105
Fax Number	:

Provider Business Practice Location Address
First Line	:	9268 E BRECKENRIDGE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-4708
Country	:	US
Telephone Number	:	314-405-1105
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TERESA HELENA HIGHTOWER
Credential	:
Telephone Number	:	314-405-1105

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/12/2025

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