Provider Demographics
NPI:1649651472
Name:OUR KINGS AND QUEENS HOME HEALTH LLC
Entity type:Organization
Organization Name:OUR KINGS AND QUEENS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAOHN COOPER
Authorized Official - Middle Name:SHAMEEKA
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-709-6861
Mailing Address - Street 1:100 S 4TH ST
Mailing Address - Street 2:SUITE 550
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63102-1800
Mailing Address - Country:US
Mailing Address - Phone:314-797-5033
Mailing Address - Fax:314-797-5001
Practice Address - Street 1:100 S 4TH ST
Practice Address - Street 2:SUITE 550
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63102-1800
Practice Address - Country:US
Practice Address - Phone:314-224-5544
Practice Address - Fax:314-797-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC9782201320900000X
MO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities