Provider Demographics
NPI:1245698760
Name:I.T.C.O.Y. IN-HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:I.T.C.O.Y. IN-HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-687-5820
Mailing Address - Street 1:7220 N LINDBERGH BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-2019
Mailing Address - Country:US
Mailing Address - Phone:314-656-1430
Mailing Address - Fax:
Practice Address - Street 1:7220 N LINDBERGH BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-2019
Practice Address - Country:US
Practice Address - Phone:314-656-1430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No251E00000XAgenciesHome Health