Mrs Octavia Home Health Care LLC

Primary specialty

Nurse's AideTaxonomy code 376K00000X

Legal business name

MRS OCTAVIA HOME HEALTH CARE LLC

Practice address

1516 Goodfellow Blvd Unit-a
1516 Goodfellow Blvd Apt-a
Saint Louis, MO 63112

Phone

(314) 226-4500

NPI assigned

Nov 15, 2023

Last updated

Nov 23, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

-As reported in NPPES

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

Authorized official

Name

Debra Edwards

Title

Owner

Phone

(314) 226-4500

Specialties & licenses 1

Addresses

Tax ID family

Mrs Octavia Home Health Care LLC2 organizations share this tax ID, including this one

Part of

Mrs Octavia Home Health Care LLC

Other organizations with this tax ID 1

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

• Mrs Octavia Home Health Care LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1114620887
  NPD tax ID

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700697600000",
    "number": "1366216897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 GOODFELLOW BLVD UNIT-A",
            "address_2": "1516 GOODFELLOW BLVD UNIT-A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63112",
            "telephone_number": "314-652-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 GOODFELLOW BLVD UNIT-A",
            "address_2": "1516 GOODFELLOW BLVD APT-A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63112",
            "telephone_number": "314-226-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRS OCTAVIA HOME HEALTH CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "-",
        "enumeration_date": "2023-11-15",
        "last_updated": "2023-11-23",
        "certification_date": "2023-11-23",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-226-4500"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Mrazik, RDH
• Margo Mriscin
• Paul Thomas Mrotek, PA-C
• Joseph Daniel Mroz, D.D.S.
• Mrs Octavia Home Health Care LLC
• Mrs Octavia Inhome Health Care Service
• MRT Medical Group.PC (County Medical Specialists)
• Petya Gancheva Mruckovski, RDH
• Gabriel Msengi, PHARMD.
• MTR, LLC

• Nurse's Aide in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nurse's Aide in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2023; 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.