Provider Demographics
NPI:1619606027
Name:SAINT LOUIS METROPOLITAN IN-HOME HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:SAINT LOUIS METROPOLITAN IN-HOME HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONTRESE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-489-7922
Mailing Address - Street 1:1194 S FLORISSANT RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-1138
Mailing Address - Country:US
Mailing Address - Phone:816-807-2470
Mailing Address - Fax:
Practice Address - Street 1:1194 S FLORISSANT RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-1138
Practice Address - Country:US
Practice Address - Phone:816-807-2470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care