HEALING WATERS OF ST LOUIS LLC (NPI# 1104473750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104473750 |
| Entity Type | Organization |
| Organization Name | HEALING WATERS OF ST LOUIS LLC |
| Practice Address |
1670 Horseshoe Dr Florissant MO 63033-2526 |
| Practice Telephone | 3143976197 |
| Mailing Telephone | 3143976197 |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |
| Authorized Official Name | ADRIENNE RENEE HARRIS (OWNER) |
| Authorized Official Telephone | 3143976197 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| Other Name | Type Code |
|---|---|
| N/A | Doing Business As Name - Organization |
| Street Address |
1670 HORSESHOE DR |
| City | FLORISSANT |
| State | MO |
| Zip Code | 63033-2526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376191841 | Victoria Crews | Technician | 13114 Tree's Edge Ct, Black Jack, MO 63033 | 2019-08-28 |
| 1275195976 | Herbal Envy Spa LLC | Home Health Aide | 12630 Shoreside Drive, Florissant, MO 63033 | 2019-07-02 |
| 1689231169 | Patrice Edora Hall | Clinic/Center | 500 Greenway Manor, Florissant, MO 63033 | 2019-05-21 |
| 1689153082 | Sew St. Louis LLC | Specialist | 2172 N Waterford Dr, Florissant, MO 63033 | 2018-08-07 |
| 1508344706 | Rekendra Farmer | Home Health | 3070 Kingsley Dr, Florissant, MO 63033 | 2018-07-31 |
| 1033616594 | B & J Consumer Directed Services | Home Health | 5 Farm Country Ct, Florissant, MO 63033 | 2018-04-11 |
| 1245740265 | Trusting Hands Home Health Services LLC | Home Health | 2430 Dresden Dr, Florissant, MO 63033 | 2017-10-04 |
| 1194243477 | Betty Moore | Registered Nurse | 2875 Devonshire Dr, Florissant, MO 63033 | 2017-09-06 |
| 1467976118 | Imperial Home Care, LLC | Home Health | 11674 Arroyo Dr, Florissant, MO 63033 | 2017-08-02 |
| 1194248492 | Apex Home Health Care Services LLC | Home Health | 3145 Kingsley Dr, Florissant, MO 63033 | 2017-07-19 |
| Find all providers in zip 63033 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295343127 | Ardella Watkins | Technician | 3878 Hirondelle Ln, Florissant, MO 63034-2308 | 2020-07-16 |
| 1790250785 | Keisha Robinson | Technician | 6943 Jamestown Way Dr, Florissant, MO 63033-5135 | 2018-10-05 |
| 1033575873 | Craig Dixson | Technician | 3904 Hermans Lake Ct, Florissant, MO 63034-1561 | 2016-01-09 |
| 1033519889 | Comfort Healthcare At Home, Inc | Technician | 6787 Blossom View Dr, Florissant, MO 63033-5133 | 2014-08-29 |
| 1598170243 | Kennyetta Chatman | Technician | 3668 Whispering Woods Dr, Florissant, MO 63031-1100 | 2014-06-20 |
| 1467876763 | Active Care Home Services, Inc | Technician | 4578 Behlmann Grove Pl, Florissant, MO 63034-2860 | 2014-02-07 |
| 1225459092 | Shauneille Conner | Technician | 3445 Amblewood Dr, Florissant, MO 63033-3902 | 2013-12-22 |
| 1932539087 | Niesha Mcdaniel | Technician | 2387 Millvalley Dr, Florissant, MO 63031-2821 | 2013-11-26 |
| 1346596772 | Monica Beatrice Perry | Technician | 14479 Rockypoint Dr, Florissant, MO 63034-2647 | 2012-08-03 |
| 1972838472 | Health Market Associates LLC | Technician | 925 N. Highway 67, Florissant, MO 63031-2917 | 2009-10-16 |
| Find all providers in FLORISSANT | ||||
| City | FLORISSANT |
| Zip Code | 63033 |
Please comment or provide details below to improve the information on HEALING WATERS OF ST LOUIS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.