Organization
HOMESTEAD HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIQUE MONTGOMERY (EXECUTIVE 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
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/20/2017
Last updated
06/09/2023
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