Provider Demographics
NPI:1053044800
Name:YOUR HOME OUR HEART CDS LLC
Entity Type:Organization
Organization Name:YOUR HOME OUR HEART CDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-449-6154
Mailing Address - Street 1:5261 DELMAR BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1013
Mailing Address - Country:US
Mailing Address - Phone:131-449-6154
Mailing Address - Fax:314-449-6153
Practice Address - Street 1:5261 DELMAR BLVD STE 315
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1013
Practice Address - Country:US
Practice Address - Phone:314-449-6154
Practice Address - Fax:314-449-6153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty