Provider Demographics
NPI:1407282189
Name:HEALEN HANDZ HOME CARE LLC
Entity Type:Organization
Organization Name:HEALEN HANDZ HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANTAY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CHARLESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-283-4360
Mailing Address - Street 1:625 N EUCLID AVE
Mailing Address - Street 2:SUITE 522
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1690
Mailing Address - Country:US
Mailing Address - Phone:314-283-4360
Mailing Address - Fax:636-244-5515
Practice Address - Street 1:625 N EUCLID AVE
Practice Address - Street 2:SUITE 522
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1690
Practice Address - Country:US
Practice Address - Phone:314-283-4360
Practice Address - Fax:636-244-5515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health