Provider Demographics
NPI:1740770049
Name:DEISTER VENTURES LLC
Entity Type:Organization
Organization Name:DEISTER VENTURES LLC
Other - Org Name:HOME HELPERS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:DEISTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:314-578-4366
Mailing Address - Street 1:16512 CENTERPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1608
Mailing Address - Country:US
Mailing Address - Phone:314-578-4366
Mailing Address - Fax:
Practice Address - Street 1:16512 CENTERPOINTE DR
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63040-1608
Practice Address - Country:US
Practice Address - Phone:314-578-4366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health