Provider Demographics
NPI:1013243658
Name:MIDWEST HOME HEALTH REHAB,INC.
Entity Type:Organization
Organization Name:MIDWEST HOME HEALTH REHAB,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:636-386-8250
Mailing Address - Street 1:14821 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7881
Mailing Address - Country:US
Mailing Address - Phone:636-386-8250
Mailing Address - Fax:636-227-0232
Practice Address - Street 1:14821 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7881
Practice Address - Country:US
Practice Address - Phone:636-386-8250
Practice Address - Fax:636-227-0232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-01
Last Update Date:2009-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02178251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health