Organization
PERSONAL CARE HOME HEALTH SVCS., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE PHILLIPS (MANAGING MEMBER)
(314) 664-1100
Entity
Organization
Contact information
Practice address
4142 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63113
(314) 664-1100
(314) 664-1104
Mailing address
4142 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63113-2730
(314) 664-1100
(314) 664-1104
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
251E00000X
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268280401
—
MO
05
—
288280407
—
MO
Enumeration date
03/08/2007
Last updated
08/12/2019
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