Provider Demographics
NPI:1306368097
Name:A DIFFERENT WORLD IN-HOME SERVICES LLC
Entity Type:Organization
Organization Name:A DIFFERENT WORLD IN-HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DANYELLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-397-1279
Mailing Address - Street 1:111 CHURCH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2457
Mailing Address - Country:US
Mailing Address - Phone:314-397-1279
Mailing Address - Fax:314-736-1388
Practice Address - Street 1:111 CHURCH ST STE 104
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2457
Practice Address - Country:US
Practice Address - Phone:314-397-1279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care