Provider Demographics
NPI:1346836517
Name:FOR THE LOVE OF HELEN MAE LLC
Entity Type:Organization
Organization Name:FOR THE LOVE OF HELEN MAE LLC
Other - Org Name:FOR THE LOVE OF HELEN MAE HOME CARE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN-KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-745-6610
Mailing Address - Street 1:2310 LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-2524
Mailing Address - Country:US
Mailing Address - Phone:314-745-6610
Mailing Address - Fax:
Practice Address - Street 1:2310 LIBERTY DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-2524
Practice Address - Country:US
Practice Address - Phone:314-745-6610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care