Provider Demographics
NPI:1518574649
Name:I AM THT I AM LLC
Entity Type:Organization
Organization Name:I AM THT I AM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHENEA
Authorized Official - Middle Name:
Authorized Official - Last Name:COWPER
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:314-704-3878
Mailing Address - Street 1:10740 SPRING GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63137-4533
Mailing Address - Country:US
Mailing Address - Phone:314-704-3878
Mailing Address - Fax:
Practice Address - Street 1:10740 SPRING GARDEN DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63137-4533
Practice Address - Country:US
Practice Address - Phone:314-704-3878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health