Organization Active NPI

Ccfe LLC

Doing business as Amada Senior Care Medicaid

  • In Home Supportive Care Agency
  • Saint Louis, MO
National Provider Identifier
1467215301
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CCFE LLC
Doing business as
Amada Senior Care Medicaid
Practice address
10097 Manchester Rd Ste 208
Saint Louis, MO 63122-1828
Phone
(314) 626-3905
Fax
(314) 626-3931
NPI assigned
Feb 2, 2024
Last updated
Feb 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Chris Fowler
Title
President
Phone
(314) 626-3905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

10097 Manchester Rd Ste 208
Saint Louis, MO 63122-1828

Mailing address

10097 Manchester Rd Ste 208
Saint Louis, MO 63122-1828
Phone (314) 626-3905

Other names 1

  • Amada Senior Care Medicaid Doing business as

National Provider Directory

National Provider Directory

Locations

10097 Manchester Rd
Ste 208
Saint Louis, MO 63122
Phone (314) 626-3905

NPI Registry JSON

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1467215301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10097 MANCHESTER RD STE 208",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631221828",
            "telephone_number": "314-626-3905",
            "fax_number": "314-626-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10097 MANCHESTER RD STE 208",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631221828",
            "telephone_number": "314-626-3905",
            "fax_number": "314-626-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-626-3905"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amada Senior Care Medicaid",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.