Provider Demographics
NPI:1629678818
Name:MODERN DAY HOME HEALTH CARE
Entity Type:Organization
Organization Name:MODERN DAY HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-368-8995
Mailing Address - Street 1:800 N TUCKER BLVD STE 453
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63101-1000
Mailing Address - Country:US
Mailing Address - Phone:314-925-8878
Mailing Address - Fax:314-925-8878
Practice Address - Street 1:800 N TUCKER BLVD STE 453
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63101-1000
Practice Address - Country:US
Practice Address - Phone:131-436-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health