Provider Demographics
NPI:1740969617
Name:HOME LIFE HEALTH CARE LLC
Entity type:Organization
Organization Name:HOME LIFE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TALIMALO
Authorized Official - Middle Name:
Authorized Official - Last Name:APELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-410-8854
Mailing Address - Street 1:914 HEMSATH RD
Mailing Address - Street 2:STE 104B UNIT 108
Mailing Address - City:ST CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303
Mailing Address - Country:US
Mailing Address - Phone:636-410-8854
Mailing Address - Fax:
Practice Address - Street 1:914 HEMSATH RD
Practice Address - Street 2:STE 104B UNIT 108
Practice Address - City:ST CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303
Practice Address - Country:US
Practice Address - Phone:636-410-8854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care