Provider Demographics
NPI:1669848305
Name:GOWDY ENTERPRISES, LLC
Entity Type:Organization
Organization Name:GOWDY ENTERPRISES, LLC
Other - Org Name:1ST CHOICE IN HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:MIRANDA
Authorized Official - Last Name:GOWDY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:314-438-0811
Mailing Address - Street 1:PO BOX 142373
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-0373
Mailing Address - Country:US
Mailing Address - Phone:314-438-0811
Mailing Address - Fax:314-438-0822
Practice Address - Street 1:9451 LACKLAND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-3627
Practice Address - Country:US
Practice Address - Phone:314-438-0811
Practice Address - Fax:314-438-0822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health