Provider Demographics
NPI:1588274872
Name:GRIFFIN HOME HEALTHCARE, LLC.
Entity type:Organization
Organization Name:GRIFFIN HOME HEALTHCARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LAKESHA
Authorized Official - Middle Name:LANAY
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:314-229-5529
Mailing Address - Street 1:4537 LOUISIANA AVE # 2B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63111-1009
Mailing Address - Country:US
Mailing Address - Phone:314-354-6595
Mailing Address - Fax:
Practice Address - Street 1:4537 LOUISIANA AVE # 2B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-1009
Practice Address - Country:US
Practice Address - Phone:314-354-6595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health