Provider Demographics
NPI:1770818908
Name:UNIVERSAL PLUS HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:UNIVERSAL PLUS HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:314-423-7900
Mailing Address - Street 1:3106 PEARL HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:ST. ANN
Mailing Address - State:MO
Mailing Address - Zip Code:63074
Mailing Address - Country:US
Mailing Address - Phone:314-423-7900
Mailing Address - Fax:314-423-7902
Practice Address - Street 1:3106 PEARL HARBOR DR
Practice Address - Street 2:
Practice Address - City:SAINT ANN
Practice Address - State:MO
Practice Address - Zip Code:63074-3809
Practice Address - Country:US
Practice Address - Phone:314-423-7900
Practice Address - Fax:314-423-7902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health