Organization
PHOENIX HOME CARE, LLC
Active
Other names
PHOENIX HOME CARE AND HOSPICE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE SCOTT HERMAN (PRESIDENT)
(316) 688-5511
Entity
Organization
Contact information
Practice address
2088 CRAIGSHIRE RD, SAINT LOUIS, MO 63146-4010
(636) 695-4330
(636) 695-4337
Mailing address
3450 N ROCK RD STE 213, WICHITA, KS 67226-1352
(316) 688-5511
(636) 695-4337
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3001163
CHAP ID
MO
01
—
935-HH
LICENSE
MO
Enumeration date
06/05/2014
Last updated
06/12/2023
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