Organization
LIFECARE MISSOURI INC.
Active
Other names
BrightStar of Kirkwood
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES E. SCARLETT (OWNER)
(630) 697-8844
Entity
Organization
Contact information
Practice address
2190 S. MASON ROAD, SUITE 204, ST. LOUIS, MO 63131
(314) 984-8650
(314) 909-1033
Mailing address
2190 S. MASON ROAD, SUITE 204, ST. LOUIS, MO 63131
(314) 984-8650
(314) 909-1033
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
835-HH
MO
251F00000X
Home Infusion Agency
835-HH
MO
251J00000X
Nursing Care Agency
835-HH
MO
253Z00000X
In Home Supportive Care Agency
835-HH
MO
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
516564
THE JOINT COMMISSION (JCAHO)
MO
01
—
835-HH
MISSOURI DEPARTMENT OF HEALTH & SENIOR SERVICES, HOME HEALTH AGENCY LICENSE
MO
Enumeration date
07/15/2009
Last updated
04/24/2012
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