Provider Demographics
NPI: | 1558848895 |
---|---|
Name: | PLEASANT NURSE HOME HEALTHCARE LLC |
Entity Type: | Organization |
Organization Name: | PLEASANT NURSE HOME HEALTHCARE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | BUSINESS OWNER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | PORTLAND |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PLEASANT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN |
Authorized Official - Phone: | 314-743-7828 |
Mailing Address - Street 1: | 5854 DELMAR BLVD. |
Mailing Address - Street 2: | SUITE B. |
Mailing Address - City: | ST. LOUIS |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63112-2308 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 314-696-8526 |
Mailing Address - Fax: | 314-696-8525 |
Practice Address - Street 1: | 5854 DELMAR BLVD. |
Practice Address - Street 2: | SUITE B. |
Practice Address - City: | ST. LOUIS |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63112-2308 |
Practice Address - Country: | US |
Practice Address - Phone: | 314-696-8526 |
Practice Address - Fax: | 314-696-8525 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-07-19 |
Last Update Date: | 2018-07-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | LC001590238 | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |