Active NPI
At Ease Home Care, Inc.
Doing business as ProvidentCare
- Home Health Agency
- Saint Louis, MO
National Provider Identifier
1255530465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 00478801
- Legal business name
- AT EASE HOME CARE, INC.
- Doing business as
- ProvidentCare
- Practice address
- 11500 Olive Blvd
Suite 176
Saint Louis, MO 63141-7143 - Phone
- (314) 531-5310
- NPI assigned
- Jul 17, 2007
- Last updated
- Jul 1, 2008
- Organization subpart
- Yes
- Parent organization
- PROVIDENT, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dan Friedman
- Title
- Officer
- Phone
- (314) 351-3510
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 00478801 | MO | Primary |
| Home Infusion Agency | 251F00000X | 00478801 | MO |
Addresses
Primary practice location
11500 Olive Blvd
Suite 176
Saint Louis, MO 63141-7143
Mailing address
11500 Olive Blvd
Suite 176
Saint Louis, MO 63141-7143
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 265298901 | Medicaid | MO | |
| 285298907 | Medicaid | MO |
Other names 1
- ProvidentCare
National Provider Directory
National Provider Directory- Part of
- Provident Inc
Locations
11500 Olive Blvd
Ste 176
Saint Louis, MO 63141
Phone (314) 531-5310
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184630400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214870400000",
"number": "1255530465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11500 OLIVE BLVD",
"address_2": "SUITE 176",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11500 OLIVE BLVD",
"address_2": "SUITE 176",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417143",
"telephone_number": "314-531-5310"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AT EASE HOME CARE, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PROVIDENT, INC.",
"enumeration_date": "2007-07-17",
"last_updated": "2008-07-01",
"status": "A",
"authorized_official_last_name": "FRIEDMAN",
"authorized_official_first_name": "DAN",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "314-351-3510"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "MO",
"license": "00478801",
"primary": true
},
{
"code": "251F00000X",
"taxonomy_group": "",
"desc": "Home Infusion",
"state": "MO",
"license": "00478801",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "265298901",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "285298907",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ProvidentCare",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Saint Louis, MO
- Astonishing Touch Adult Day Center, LLC
- Astonishing Touch Home Health & Senior Services L.L.C.
- Astoria Gardens and Rehab Center
- Awuri Asuru, MD PHD
- Yasmin Asvat, PH.D.
- At Eaze Home Health LLC
- At Home Medical Equipment Inc
- At Home Personal Care in Home Services LLC
- At Home Personal Care LLC
- At Home-Home Care & CDS LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.