Provider Demographics
NPI:1215241500
Name:KNOWING GENERATIONS HOME HEALTH
Entity type:Organization
Organization Name:KNOWING GENERATIONS HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DESIGNATED MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:T
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-246-0035
Mailing Address - Street 1:5 GIMLIN PL
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-1503
Mailing Address - Country:US
Mailing Address - Phone:314-246-0035
Mailing Address - Fax:
Practice Address - Street 1:5 GIMLIN PL
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138-1503
Practice Address - Country:US
Practice Address - Phone:314-246-0035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KNOWING GENERATIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175L00000XOther Service ProvidersHomeopathGroup - Multi-Specialty