Provider Demographics
NPI:1992363923
Name:FROM OUR HEART 2 YOURS HOMECARE LLC MO CDS
Entity Type:Organization
Organization Name:FROM OUR HEART 2 YOURS HOMECARE LLC MO CDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEERS-BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-294-2755
Mailing Address - Street 1:3910 S OLD HIGHWAY 94 STE 114
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-2834
Mailing Address - Country:US
Mailing Address - Phone:636-294-2755
Mailing Address - Fax:636-294-2950
Practice Address - Street 1:3910 S OLD HIGHWAY 94 STE 114
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-2834
Practice Address - Country:US
Practice Address - Phone:636-294-2755
Practice Address - Fax:636-294-2950
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FROM OUR HEART 2 YOURS HOMECARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-04
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0017887Medicaid