# AGING WELL HEALTH CARE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215936588
- **Authorized official:** IRINA BURSAK (ADMINISTRATOR)
- **Authorized official phone:** (314) 726-5600

## Contact information

- **Practice address:** 7212 BALSON AVE, SAINT LOUIS, MO 63130-3001
- **Practice address phone:** (314) 726-5600
- **Practice address fax:** (314) 754-9317
- **Mailing address:** 7212 BALSON AVE, SAINT LOUIS, MO 63130-3001
- **Mailing address phone:** (314) 726-5600
- **Mailing address fax:** (314) 754-9317

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1010588 | IL | — |
| 251E00000X | Home Health Agency | 755 | MO | Yes |
| 251J00000X | Nursing Care Agency | 265855403 | MO | — |
| 261QA0600X | Adult Day Care Clinic/Center | 609 | MO | — |
| 261QP2000X | Physical Therapy Clinic/Center | 266633 | MO | — |
| 261QX0100X | Occupational Medicine Clinic/Center | 266633 | MO | — |
| 385H00000X | Respite Care | 285855409 | MO | — |

## Other

- **Enumeration date:** 07/19/2005
- **Last updated:** 09/20/2010