Organization
EXPRESS HOME CARE
Active
Other names
Express Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SHELTON (ADMINISTRATOR)
(314) 727-0453
Entity
Organization
Contact information
Practice address
3641 OAKDALE AVE, SAINT LOUIS, MO 63121
(314) 727-0453
(314) 727-6067
Mailing address
3641 OAKDALE AVE, SAINT LOUIS, MO 63121-5437
(314) 727-0453
(314) 727-6067
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009458
—
MO
05
—
1679746077
—
MO
Enumeration date
03/11/2008
Last updated
08/01/2024
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