Provider Demographics
NPI:1952770620
Name:GENTLECARE HOME HEALTH CDS SERVICE LLC
Entity type:Organization
Organization Name:GENTLECARE HOME HEALTH CDS SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-429-6030
Mailing Address - Street 1:3111 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-4911
Mailing Address - Country:US
Mailing Address - Phone:314-429-6030
Mailing Address - Fax:314-429-6155
Practice Address - Street 1:3111 BROWN RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-4911
Practice Address - Country:US
Practice Address - Phone:314-429-6030
Practice Address - Fax:314-429-6155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health