Provider Demographics
NPI:1003249509
Name:EXCEPTIONAL LOVING HOME HEALTHCARE
Entity Type:Organization
Organization Name:EXCEPTIONAL LOVING HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-810-2501
Mailing Address - Street 1:7914 COOL VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-2023
Mailing Address - Country:US
Mailing Address - Phone:314-810-2501
Mailing Address - Fax:314-521-8097
Practice Address - Street 1:1515 N WARSON RD
Practice Address - Street 2:SUITE 113E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-1111
Practice Address - Country:US
Practice Address - Phone:314-810-2501
Practice Address - Fax:314-521-8097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care