Provider Demographics
NPI:1043858236
Name:STAY HOME CAREGIVERS, LLC
Entity Type:Organization
Organization Name:STAY HOME CAREGIVERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-283-9028
Mailing Address - Street 1:2203 W JEFFERSON ST STE A
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-1465
Mailing Address - Country:US
Mailing Address - Phone:618-283-9028
Mailing Address - Fax:618-259-4201
Practice Address - Street 1:2203 W JEFFERSON ST STE A
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-1465
Practice Address - Country:US
Practice Address - Phone:618-283-9028
Practice Address - Fax:618-259-4201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care