Provider Demographics
NPI:1669980611
Name:STRATEGIC HOME HEALTH CARE
Entity type:Organization
Organization Name:STRATEGIC HOME HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:314-553-0552
Mailing Address - Street 1:5200 HELEN AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-3404
Mailing Address - Country:US
Mailing Address - Phone:314-553-0552
Mailing Address - Fax:314-553-0553
Practice Address - Street 1:5200 HELEN AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:MO
Practice Address - Zip Code:63136-3404
Practice Address - Country:US
Practice Address - Phone:314-553-0552
Practice Address - Fax:314-553-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO=========Medicaid