Provider Demographics
NPI:1922449750
Name:CONTINUUM HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:CONTINUUM HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER/DON
Authorized Official - Prefix:
Authorized Official - First Name:KIMMARA
Authorized Official - Middle Name:PATTRICE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CCM
Authorized Official - Phone:314-704-6204
Mailing Address - Street 1:1021 N GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63106-1641
Mailing Address - Country:US
Mailing Address - Phone:314-704-6204
Mailing Address - Fax:
Practice Address - Street 1:1021 N GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106-1641
Practice Address - Country:US
Practice Address - Phone:314-704-6204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health