Provider Demographics
NPI:1245758671
Name:CONVENIENT HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:CONVENIENT HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIYANNA
Authorized Official - Middle Name:I
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-448-2136
Mailing Address - Street 1:3159 FEE FEE RD STE 206
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-3299
Mailing Address - Country:US
Mailing Address - Phone:314-448-2136
Mailing Address - Fax:
Practice Address - Street 1:3159 FEE FEE RD STE 206
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-3299
Practice Address - Country:US
Practice Address - Phone:314-448-2136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health