Provider Demographics
NPI:1154055507
Name:SUSTAINABLE HOME HEALTH LLC
Entity type:Organization
Organization Name:SUSTAINABLE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAHNAE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-479-0913
Mailing Address - Street 1:10649 HALLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-5713
Mailing Address - Country:US
Mailing Address - Phone:314-438-5825
Mailing Address - Fax:
Practice Address - Street 1:10649 HALLWOOD DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-5713
Practice Address - Country:US
Practice Address - Phone:314-438-5825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUSTAINABLE HOME HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management