Provider Demographics
NPI:1275299372
Name:REALITY HEALTHCARE LLC
Entity Type:Organization
Organization Name:REALITY HEALTHCARE LLC
Other - Org Name:REALITY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TEKISHA
Authorized Official - Middle Name:DARSHA
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-304-2747
Mailing Address - Street 1:3428 CHARLESTOWNE CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-4892
Mailing Address - Country:US
Mailing Address - Phone:314-304-2747
Mailing Address - Fax:
Practice Address - Street 1:415 CHEZ PAREE DR STE E
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-3599
Practice Address - Country:US
Practice Address - Phone:314-304-2747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1275299372Medicaid