Organization
ROOTS HEALTHCARE AND HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALARIE B. PHILLIPS (PRESIDENT MEDICAL MANAGEMENT)
(760) 270-3791
Entity
Organization
Contact information
Practice address
4300 ENRIGHT AVE, ST. LOUIS, MO 63108
(760) 270-3791
Mailing address
292 PICKENS CIR, CARTHAGE, MS 39051-7982
(760) 270-3791
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
CA
251B00000X
Case Management Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
—
—
310400000X
Assisted Living Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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