Provider Demographics
NPI:1295281756
Name:ROBERTA'S HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:ROBERTA'S HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-324-8721
Mailing Address - Street 1:1115 WATER VIEW LN
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-1477
Mailing Address - Country:US
Mailing Address - Phone:314-324-8721
Mailing Address - Fax:636-294-7062
Practice Address - Street 1:1555 KISKER RD
Practice Address - Street 2:STE 126
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-0602
Practice Address - Country:US
Practice Address - Phone:314-324-8721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care