Provider Demographics
NPI:1881906824
Name:WISE CHOICE INHOME SERVICES LLC
Entity type:Organization
Organization Name:WISE CHOICE INHOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-646-9997
Mailing Address - Street 1:9953 LEWIS AND CLARK BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-5307
Mailing Address - Country:US
Mailing Address - Phone:314-868-9900
Mailing Address - Fax:314-868-9902
Practice Address - Street 1:9953 LEWIS AND CLARK BLVD STE 203
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-5307
Practice Address - Country:US
Practice Address - Phone:314-868-9900
Practice Address - Fax:314-868-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health