Provider Demographics
NPI:1134769334
Name:ANOINTING LOVING CARE IN HOME LLC
Entity type:Organization
Organization Name:ANOINTING LOVING CARE IN HOME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:REID ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-899-0292
Mailing Address - Street 1:9191 W FLORISSANT AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-1424
Mailing Address - Country:US
Mailing Address - Phone:314-801-7692
Mailing Address - Fax:314-274-7542
Practice Address - Street 1:5648 DR MARTIN LUTHER KING DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-3933
Practice Address - Country:US
Practice Address - Phone:314-899-0292
Practice Address - Fax:314-899-0291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO260039901Medicaid