Provider Demographics
NPI:1821207358
Name:THE HOME TEAM HOME HEALTH SERVICES & ADULT DAYCARE LLC
Entity Type:Organization
Organization Name:THE HOME TEAM HOME HEALTH SERVICES & ADULT DAYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SPARKS
Authorized Official - Middle Name:ANDERSON
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:314-922-3208
Mailing Address - Street 1:6600 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63111-2903
Mailing Address - Country:US
Mailing Address - Phone:314-922-3208
Mailing Address - Fax:314-448-1891
Practice Address - Street 1:6407 MICHIGAN AVE OFC
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-2802
Practice Address - Country:US
Practice Address - Phone:314-922-3208
Practice Address - Fax:314-448-1891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
267608Medicare Oscar/Certification