Provider Demographics
NPI:1326311184
Name:COMPREHENSIVE HOME CARE LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-349-2311
Mailing Address - Street 1:1749 GILSINN LN
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-2008
Mailing Address - Country:US
Mailing Address - Phone:636-349-2311
Mailing Address - Fax:636-349-6491
Practice Address - Street 1:1451 HIGH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-6490
Practice Address - Country:US
Practice Address - Phone:636-390-9510
Practice Address - Fax:636-390-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO746-8HH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
267579OtherMEDICARE