Provider Demographics
NPI:1841916764
Name:ANNIE'S HOUSE, INC.
Entity type:Organization
Organization Name:ANNIE'S HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-979-6053
Mailing Address - Street 1:25228 BUZZARD DR
Mailing Address - Street 2:
Mailing Address - City:MARBLE HILL
Mailing Address - State:MO
Mailing Address - Zip Code:63764-7481
Mailing Address - Country:US
Mailing Address - Phone:573-979-6053
Mailing Address - Fax:573-238-1302
Practice Address - Street 1:25228 BUZZARD DR
Practice Address - Street 2:
Practice Address - City:MARBLE HILL
Practice Address - State:MO
Practice Address - Zip Code:63764-7481
Practice Address - Country:US
Practice Address - Phone:573-238-1300
Practice Address - Fax:573-238-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility