Provider Demographics
NPI:1427701838
Name:EXCELLENT HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:EXCELLENT HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-437-7549
Mailing Address - Street 1:100 SOUTH 4TH STREET
Mailing Address - Street 2:STE 550
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63102
Mailing Address - Country:US
Mailing Address - Phone:314-857-5339
Mailing Address - Fax:314-769-9859
Practice Address - Street 1:100 SOUTH 4TH STREET
Practice Address - Street 2:STE 550
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63102
Practice Address - Country:US
Practice Address - Phone:314-857-5339
Practice Address - Fax:314-769-9859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health