Provider Demographics
NPI:1548745144
Name:YOUR FAMILY MATTERS HEALTH CARE LLC
Entity Type:Organization
Organization Name:YOUR FAMILY MATTERS HEALTH CARE LLC
Other - Org Name:YOUR FAMILY MATTERS CDS HEALTH CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-830-1443
Mailing Address - Street 1:2055 WALTON RD STE 311
Mailing Address - Street 2:
Mailing Address - City:OVERLAND
Mailing Address - State:MO
Mailing Address - Zip Code:63114-5805
Mailing Address - Country:US
Mailing Address - Phone:618-830-1443
Mailing Address - Fax:
Practice Address - Street 1:2055 WALTON RD STE 311
Practice Address - Street 2:
Practice Address - City:OVERLAND
Practice Address - State:MO
Practice Address - Zip Code:63114-5805
Practice Address - Country:US
Practice Address - Phone:618-830-1443
Practice Address - Fax:314-216-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO001611523OtherHEALTH CARE
MO001611523Medicaid