Provider Demographics
NPI:1659408102
Name:HOME CARE SERVICES OF METROPOLITAN ST LOUIS LTD
Entity Type:Organization
Organization Name:HOME CARE SERVICES OF METROPOLITAN ST LOUIS LTD
Other - Org Name:METRO HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-863-1040
Mailing Address - Street 1:201 S CENTRAL AVE
Mailing Address - Street 2:#108
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3517
Mailing Address - Country:US
Mailing Address - Phone:314-863-1040
Mailing Address - Fax:314-863-3257
Practice Address - Street 1:201 S CENTRAL AVE
Practice Address - Street 2:#108
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-3517
Practice Address - Country:US
Practice Address - Phone:314-863-1040
Practice Address - Fax:314-863-3257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO26 1711303Medicaid
MO0000224OtherSSBG BLOCK GRANT
MO28 1711309Medicaid