Provider Demographics
NPI:1760086326
Name:INTIMATE CARE CDS LLC
Entity Type:Organization
Organization Name:INTIMATE CARE CDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TEARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-565-7629
Mailing Address - Street 1:4110 7 HILLS DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6708
Mailing Address - Country:US
Mailing Address - Phone:314-745-2926
Mailing Address - Fax:
Practice Address - Street 1:4110 7 HILLS DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6708
Practice Address - Country:US
Practice Address - Phone:314-745-2926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health