Provider Demographics
NPI:1922541341
Name:HOME ASSIST
Entity Type:Organization
Organization Name:HOME ASSIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KESU
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-575-9064
Mailing Address - Street 1:2241 COUNTRY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62221-2560
Mailing Address - Country:US
Mailing Address - Phone:618-624-0493
Mailing Address - Fax:188-867-2281
Practice Address - Street 1:2241 COUNTRY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62221-2560
Practice Address - Country:US
Practice Address - Phone:618-624-0493
Practice Address - Fax:188-867-2281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-03
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care