Homestead Health Care LLC

Organization Active NPI In Home Supportive Care Agency · Black Jack, MO

NPI 1053825596 · NPPES record last updated Jun 9, 2023

Key facts

NPI
1053825596
Entity type
Organization (NPI type 2)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Legal business name
HOMESTEAD HEALTH CARE LLC
Practice address
12405 Old Halls Ferry Rd Ste 100
Black Jack, MO 63033-4261
Phone
(314) 757-9535
NPI assigned
Nov 20, 2017
Organization subpart
No

Authorized official

Name
Monique Montgomery
Title
Executive Director
Phone
(314) 395-3006

National Provider Directory

Locations

12405 Old Halls Ferry Rd
Ste 100
Black Jack, MO 63033
Phone (314) 757-9535

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X Yes

Addresses

Primary practice location

12405 Old Halls Ferry Rd Ste 100
Black Jack, MO 63033-4261

Mailing address

12405 Old Halls Ferry Rd Ste 100
Black Jack, MO 63033-4261

Other providers in Black Jack, MO

All providers in Black Jack, MO · In Home Supportive Care Agency in Missouri

Sources for this page

Verify at the official NPI Registry.