MEDICARE: EDUHEALTH PERSONAL CARE SERVICES

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	3747P1801X	Personal Care Attendant
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1922646728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDUHEALTH PERSONAL CARE SERVICES

Provider Business Mailing Address
First Line	:	5843 EAGLE VALLEY DR SAINT LOUIS MO 63136
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136
Country	:	US
Telephone Number	:	314-371-7717
Fax Number	:

Provider Business Practice Location Address
First Line	:	5843 EAGLE VALLEY DR SAINT LOUIS MO 63136
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136
Country	:	US
Telephone Number	:	314-371-7717
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TINNYAH BRANDON
Credential	:
Telephone Number	:	314-371-7717

Provider Enumeration Date	:	12/12/2019
Last Update Date	:	11/27/2023

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