Prolific Care Consumer Direct Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PROLIFIC CARE CONSUMER DIRECT SERVICES LLC

Practice address

1243 Advance Dr
Florissant, MO 63031-1421

Phone

(636) 362-3539

NPI assigned

Jan 14, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Jeonne Harris

Title

Executive Director

Phone

(636) 362-3539

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1083365654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 ADVANCE DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630311421",
            "telephone_number": "636-362-3539",
            "fax_number": "314-834-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 ADVANCE DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630311421",
            "telephone_number": "636-362-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIFIC CARE CONSUMER DIRECT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-14",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JEONNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "636-362-3539",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Florissant, MO
• Providers in Florissant, MO by specialty
• In Home Supportive Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.