Provider Demographics
NPI:1437545068
Name:ASSISTED DAILY LIVING IN-HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ASSISTED DAILY LIVING IN-HOME HEALTH SERVICES LLC
Other - Org Name:GOOD HYDRATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-273-2700
Mailing Address - Street 1:1360 S 5TH ST
Mailing Address - Street 2:SUITE 356
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2449
Mailing Address - Country:US
Mailing Address - Phone:844-273-2700
Mailing Address - Fax:636-724-4304
Practice Address - Street 1:1360 S 5TH ST
Practice Address - Street 2:SUITE 356
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2449
Practice Address - Country:US
Practice Address - Phone:844-273-2700
Practice Address - Fax:636-724-4304
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD HYDRATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-10
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No291U00000XLaboratoriesClinical Medical Laboratory
No385H00000XRespite Care FacilityRespite Care