Provider Demographics
NPI:1053082602
Name:SIGNATURE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:SIGNATURE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:NAWON
Authorized Official - Middle Name:SHERNICE
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-762-7665
Mailing Address - Street 1:7320 FLORISSANT RD # 1A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-2526
Mailing Address - Country:US
Mailing Address - Phone:314-762-7665
Mailing Address - Fax:314-383-0543
Practice Address - Street 1:7320 FLORISSANT RD # 1A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-2526
Practice Address - Country:US
Practice Address - Phone:314-762-7665
Practice Address - Fax:314-383-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health