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Organization

FORUM HOME HEALTH AGENCY LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NELIIE TSIMERMAN (OWNER ADMINISTRATOR)
(314) 369-2056
Entity
Organization

Contact information

Practice address
3828 MERAMEC ST, SAINT LOUIS, MO 63116-4470
(314) 369-2056
(314) 353-3882
Mailing address
3828 MERAMEC ST, SAINT LOUIS, MO 63116-4470
(314) 369-2056
(314) 353-3882

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
LC6820830
MO
261QA0600X
Adult Day Care Clinic/Center
Primary
814
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
265863209
MO
05
285863205
MO
Enumeration date
03/22/2007
Last updated
05/08/2009
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