Provider Demographics
NPI:1548158140
Name:MOMENTS HOSPICE OF ST LOUIS LLC
Entity type:Organization
Organization Name:MOMENTS HOSPICE OF ST LOUIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIYAHU
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-220-6002
Mailing Address - Street 1:820 LILAC DR N STE 210
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4754
Mailing Address - Country:US
Mailing Address - Phone:877-666-3687
Mailing Address - Fax:
Practice Address - Street 1:11960 INDUSTRIAL DRIVE
Practice Address - Street 2:SUITE 331
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146
Practice Address - Country:US
Practice Address - Phone:877-666-3687
Practice Address - Fax:763-205-9350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based