Aging Well Health Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010588 Issued in IL

Legal business name

AGING WELL HEALTH CARE, LLC

Practice address

540 Regency Ctr
Collinsville, IL 62234-4658

Phone

(618) 344-8800

Fax

(618) 344-8020

NPI assigned

Oct 3, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Irina Bursak

Title

Administrator

Phone

(314) 726-5600

Specialties & licenses 1

Addresses

Other names 1

• AW Health Care Doing business as

Tax ID family

Aw Health Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Aging Well Health Care, LLC

  • Physical Therapy Clinic/Center
  • Saint Louis, MO
  • NPI 1184470809
  NPD tax ID

Locations

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1295087195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 BALSON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631303001",
            "telephone_number": "314-726-5600",
            "fax_number": "314-754-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 REGENCY CTR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344658",
            "telephone_number": "618-344-8800",
            "fax_number": "618-344-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGING WELL HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "BURSAK",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-726-5600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AW Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 3F Vision LLC
• Ace Physical Therapy and Rehab Specialists LLC
• Adapt of Illinois, Inc.
• Diedra M Ahlert, CPNP-PC
• Makin Uddin Ahmed, MD
• American Homepatient, Inc.
• Kevin Wayne Ames, DVM
• Apex Physical Therapy, LLC

• All providers in Collinsville, IL
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.