Provider Demographics
NPI:1578852521
Name:JANELLE STOWERS
Entity Type:Organization
Organization Name:JANELLE STOWERS
Other - Org Name:KAMKEN CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-341-3293
Mailing Address - Street 1:320 BROOKES DR
Mailing Address - Street 2:SUITE 237
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-2736
Mailing Address - Country:US
Mailing Address - Phone:314-731-1563
Mailing Address - Fax:314-667-3083
Practice Address - Street 1:320 BROOKES DR
Practice Address - Street 2:SUITE 237
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-2736
Practice Address - Country:US
Practice Address - Phone:314-731-1563
Practice Address - Fax:314-667-3083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1578852521Medicaid