Provider Demographics
NPI:1851839666
Name:YOUR HOME OUR HEART
Entity Type:Organization
Organization Name:YOUR HOME OUR HEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-322-5702
Mailing Address - Street 1:5261 DELMAR BLVD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1063
Mailing Address - Country:US
Mailing Address - Phone:314-322-5702
Mailing Address - Fax:
Practice Address - Street 1:5261 DELMAR BLVD
Practice Address - Street 2:SUITE 315
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1063
Practice Address - Country:US
Practice Address - Phone:314-322-5702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health