Provider Demographics
NPI:1609133990
Name:AWESOME CARE LLC
Entity Type:Organization
Organization Name:AWESOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:DICKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-686-0234
Mailing Address - Street 1:1360 S 5TH ST STE 346
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2447
Mailing Address - Country:US
Mailing Address - Phone:314-686-0234
Mailing Address - Fax:
Practice Address - Street 1:1360 S 5TH ST STE 346
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2447
Practice Address - Country:US
Practice Address - Phone:314-686-0234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care