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Organization
HOMESTEAD HEALTH CARE IHS LLC
Active
Organization
HOMESTEAD HEALTH CARE IHS LLC
Active
Other names
Homestead Health Care IHS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MONIQUE MONTGOMERY (EXCUTIVE DIRECTOR)
(314) 395-3006
Entity
Organization
Contact information
Practice address
12405 OLD HALLS FERRY RD STE 100, BLACK JACK, MO 63033-4261
(314) 757-9535
Mailing address
12405 OLD HALLS FERRY RD STE 100, BLACK JACK, MO 63033-4261
(314) 395-3006
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/03/2020
Last updated
06/09/2023
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