Provider Demographics
NPI:1538315379
Name:MISSOURI HOME CARE ASSOCIATES
Entity Type:Organization
Organization Name:MISSOURI HOME CARE ASSOCIATES
Other - Org Name:PREFERRED CARE AT HOME OF MISSOURI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:NOLTING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-650-1892
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-0005
Mailing Address - Country:US
Mailing Address - Phone:314-650-1892
Mailing Address - Fax:
Practice Address - Street 1:5988 MID RIVERS MALL DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63304-7119
Practice Address - Country:US
Practice Address - Phone:314-623-8990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health