# AGING WELL HEALTH CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AW Health Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295087195
- **Authorized official:** MRS. IRINA BURSAK (ADMINISTRATOR)
- **Authorized official phone:** (314) 726-5600

## Contact information

- **Practice address:** 540 REGENCY CTR, COLLINSVILLE, IL 62234-4658
- **Practice address phone:** (618) 344-8800
- **Practice address fax:** (618) 344-8020
- **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 | Yes |

## Other

- **Enumeration date:** 10/03/2012
- **Last updated:** 10/03/2012