# 4TH GENERATION HOME CARE SERVICES LLC

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

## Provider details

- **NPI number:** 1942700349
- **Authorized official:** NACOLE TAYLOR (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (314) 971-9784

## Contact information

- **Practice address:** 2110 MCLARAN AVE, SAINT LOUIS, MO 63136-3850
- **Practice address phone:** (314) 971-9784
- **Mailing address:** 2110 MCLARAN AVE, SAINT LOUIS, MO 63136-3850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/13/2018
- **Last updated:** 02/13/2018