Provider Demographics
NPI:1992567275
Name:WENDO HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:WENDO HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NONI
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNGAI
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:314-648-4038
Mailing Address - Street 1:10201 SYRAH CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63304-1137
Mailing Address - Country:US
Mailing Address - Phone:314-648-4038
Mailing Address - Fax:
Practice Address - Street 1:5377 HIGHWAY N
Practice Address - Street 2:
Practice Address - City:COTTLEVILLE
Practice Address - State:MO
Practice Address - Zip Code:63304-8032
Practice Address - Country:US
Practice Address - Phone:314-648-4038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health