Provider Demographics
NPI:1710107149
Name:ENDLESS CARE HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:ENDLESS CARE HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LARONDA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:BSBM
Authorized Official - Phone:314-355-1700
Mailing Address - Street 1:12406 LUSHER RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-1456
Mailing Address - Country:US
Mailing Address - Phone:314-355-1700
Mailing Address - Fax:314-355-1743
Practice Address - Street 1:12406 LUSHER RD STE A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138-1456
Practice Address - Country:US
Practice Address - Phone:314-355-1700
Practice Address - Fax:314-355-1743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO264759602Medicaid