Provider Demographics
NPI:1851757538
Name:FORGET ME NOT IN HOME HEALTH CARE LLC.
Entity Type:Organization
Organization Name:FORGET ME NOT IN HOME HEALTH CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSHANDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-498-3237
Mailing Address - Street 1:3910 S OLD HIGHWAY 94
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-2834
Mailing Address - Country:US
Mailing Address - Phone:314-498-3237
Mailing Address - Fax:
Practice Address - Street 1:3910 S OLD HIGHWAY 94
Practice Address - Street 2:SUITE 109
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-2834
Practice Address - Country:US
Practice Address - Phone:314-498-3237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO22654356305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service