Academy Home Care Services, LLC

Primary specialty

Chore ProviderTaxonomy code 372500000X

Legal business name

ACADEMY HOME CARE SERVICES, LLC

Practice address

355 Ozark Trail Dr Ste 2
Ellisville, MO 63011-2164

Phone

(636) 527-1770

Fax

(636) 527-1796

NPI assigned

Apr 22, 2019

Last updated

Apr 26, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Teresa Imboden

Title

Human Resources Manager

Phone

(636) 527-1770

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556236800000",
    "number": "1053974394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 OZARK TRAIL DR STE 2",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112164",
            "telephone_number": "636-527-1770",
            "fax_number": "636-527-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 OZARK TRAIL DR STE 2",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112164",
            "telephone_number": "636-527-1770",
            "fax_number": "636-527-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMY HOME CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-26",
        "status": "A",
        "authorized_official_last_name": "IMBODEN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "HUMAN RESOURCES MANAGER",
        "authorized_official_telephone_number": "636-527-1770",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M266035500",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chore Provider in Ellisville, MO
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• Chore Provider in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.