Provider Demographics
NPI:1972276764
Name:EANAJ CARE HOME HEALTH LLC
Entity type:Organization
Organization Name:EANAJ CARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAYHORN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:636-346-4914
Mailing Address - Street 1:1729 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-2128
Mailing Address - Country:US
Mailing Address - Phone:636-346-4914
Mailing Address - Fax:
Practice Address - Street 1:8730 BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-3776
Practice Address - Country:US
Practice Address - Phone:314-393-6701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health