Idalia Blue'S Home Health LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

IDALIA BLUE'S HOME HEALTH LLC

Practice address

10174 W Florissant Ave Ste 319
Saint Louis, MO 63136-2104

Phone

(636) 328-9664

NPI assigned

Apr 18, 2023

Organization subpart

No

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

Authorized official

Name

Tricia Coleman

Title

Managing Member

Phone

(636) 328-9664

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1104513415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 GREER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631215617",
            "telephone_number": "636-328-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10174 W FLORISSANT AVE STE 319",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631362104",
            "telephone_number": "636-328-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDALIA BLUE'S HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-18",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "636-328-9664"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Icenogle, PHARMD
• Nneka Udonna Ichoku, D.O., MPH
• Miranda A Ickler
• Iconic Services Inc
• Idalia Blue'S Home Health II LLC
• Ideal Home Care LLC
• Ideal Pediatric Wellness, LLC
• Ideal Special Services LLC
• Henry Charles Ideker, MD
• Renee D Idel, ANP

• In Home Supportive Care Agency in Saint Louis, MO
• Providers in Saint Louis, 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 Jan 25, 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.