Provision Home Care Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

CC0635954 Issued in MO

Legal business name

PROVISION HOME CARE INC.

Practice address

9378 Olive Blvd
Suite 215
Saint Louis, MO 63132-3215

Phone

(314) 569-4121

Fax

(314) 569-4118

NPI assigned

Mar 12, 2007

Last updated

Aug 22, 2020By 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

Mr. Kenneth Millard Roberts

Title

Biller

Phone

(314) 569-4121

Specialties & licenses 1

Addresses

Tax ID family

Provision Home Care Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Provision Home Care Inc

  • In Home Supportive Care Agency
  • Olivette, MO
  • NPI 1700259264
  NPD tax ID
• Provision Home Care Inc.

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1992775746
  NPD tax ID

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124150511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9378 OLIVE BLVD",
            "address_2": "SUITE 215",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323215",
            "telephone_number": "314-569-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9378 OLIVE BLVD",
            "address_2": "SUITE 215",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323215",
            "telephone_number": "314-569-4121",
            "fax_number": "314-569-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION HOME CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "MILLARD",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "314-569-4121",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "CC0635954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Provident Inc (Provident Behavioral Health)
• Provident Inc. (Provident Behavioral Health)
• Provident Place Consumer Directed Services
• Provider Plus LLC (AdaptHealth)
• Darrell Provinse, L.P.C.
• Provision Home Care Inc.
• Provital Home Health Care Services
• Tanika Joi Prowell, RN
• Carly Pruemer, CRNA
• Tessa Pruemer, LMSW

• Home Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.