Provider Demographics
NPI:1083054175
Name:ALL LOVING CARE CONSUMER DIRECTED SERVICES
Entity Type:Organization
Organization Name:ALL LOVING CARE CONSUMER DIRECTED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCHELLI
Authorized Official - Middle Name:GENEVIEVE
Authorized Official - Last Name:JEMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-739-4673
Mailing Address - Street 1:3006 N LINDBERGH BLVD STE 709
Mailing Address - Street 2:
Mailing Address - City:SAINT ANN
Mailing Address - State:MO
Mailing Address - Zip Code:63074-3242
Mailing Address - Country:US
Mailing Address - Phone:314-739-4673
Mailing Address - Fax:
Practice Address - Street 1:3006 N LINDBERGH BLVD STE 709
Practice Address - Street 2:
Practice Address - City:SAINT ANN
Practice Address - State:MO
Practice Address - Zip Code:63074-3242
Practice Address - Country:US
Practice Address - Phone:314-739-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health