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Organization

COOPERATIVE HOME CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MITCH I WAKS (CEO & OWNER)
(314) 772-8585
Entity
Organization

Contact information

Practice address
1924 MARCONI AVE, SAINT LOUIS, MO 63110-3038
(314) 772-8585
(314) 772-2820
Mailing address
1924 MARCONI AVE, SAINT LOUIS, MO 63110-3038
(314) 772-8585
(314) 772-2820

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0001287
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
262335706
MO
05
282335702
MO
05
5149347
MO
05
852335702
MO
Enumeration date
01/08/2007
Last updated
03/26/2019
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