Provider Demographics
NPI:1225896160
Name:INFINIUM HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:INFINIUM HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDISS
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:934-947-2930
Mailing Address - Street 1:1000 MID RIVERS MALL DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2171
Mailing Address - Country:US
Mailing Address - Phone:934-947-2930
Mailing Address - Fax:636-387-0722
Practice Address - Street 1:1000 MID RIVERS MALL DR STE 4
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2171
Practice Address - Country:US
Practice Address - Phone:934-947-2930
Practice Address - Fax:636-387-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care