Provider Demographics
NPI:1033566427
Name:MOTIVATE HEALTHCARE IN-HOME LLC
Entity Type:Organization
Organization Name:MOTIVATE HEALTHCARE IN-HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-580-4233
Mailing Address - Street 1:315 LEMAY FERRY RD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:LEMAY
Mailing Address - State:MO
Mailing Address - Zip Code:63125-1501
Mailing Address - Country:US
Mailing Address - Phone:314-669-9760
Mailing Address - Fax:
Practice Address - Street 1:315 LEMAY FERRY RD
Practice Address - Street 2:SUITE 135
Practice Address - City:LEMAY
Practice Address - State:MO
Practice Address - Zip Code:63125-1501
Practice Address - Country:US
Practice Address - Phone:314-669-9760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO153557251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO280026528Medicaid
MO260026527Medicaid