Provider Demographics
NPI:1215528757
Name:EXPERIENCED IN-HOME CARE & ASSISTANCE LLC
Entity type:Organization
Organization Name:EXPERIENCED IN-HOME CARE & ASSISTANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BADWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-525-5445
Mailing Address - Street 1:14824 CLAYTON ROAD
Mailing Address - Street 2:SUITE 19
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7888
Mailing Address - Country:US
Mailing Address - Phone:636-525-5445
Mailing Address - Fax:636-525-5446
Practice Address - Street 1:14824 CLAYTON ROAD
Practice Address - Street 2:SUITE 19
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7888
Practice Address - Country:US
Practice Address - Phone:636-525-5445
Practice Address - Fax:636-525-5446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOLC001704880OtherARTICLES IF INCORPORATION