Provider Demographics
NPI:1073930657
Name:ST LOUIS HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:ST LOUIS HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROLLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-327-3462
Mailing Address - Street 1:1425 LEROY AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63133-1723
Mailing Address - Country:US
Mailing Address - Phone:314-769-9818
Mailing Address - Fax:
Practice Address - Street 1:1425 LEROY AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63133-1723
Practice Address - Country:US
Practice Address - Phone:314-327-3462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health