A Zenful Experience Home Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

A ZENFUL EXPERIENCE HOME HEALTH CARE LLC

Practice address

5019 Ulena Ave
Saint Louis, MO 63116-3333

Phone

(314) 478-0292

Fax

(314) 733-5202

NPI assigned

Oct 30, 2021

Organization subpart

No

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

Authorized official

Name

Everlena Mack, DO

Title

Director

Phone

(314) 478-0292

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• A Zenful Experience Home Health Care LLC Former legal business name

Electronic endpoints 2

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

{
    "created_epoch": "1635552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635552000000",
    "number": "1104580620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 ULENA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631163333",
            "telephone_number": "314-478-0292",
            "fax_number": "314-733-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5019 ULENA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631163333",
            "telephone_number": "314-478-0292",
            "fax_number": "314-733-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A ZENFUL EXPERIENCE HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-30",
        "last_updated": "2021-10-30",
        "certification_date": "2021-10-30",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "EVERLENA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-478-0292",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372500000X",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "everlena_mack@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5019 Ulena Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631163333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "everlena_mack@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5019 Ulena Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631163333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "A Zenful Experience Home Health Care LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2021; 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.