Forum Home Health Agency LLC.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

814 Issued in MO

Legal business name

FORUM HOME HEALTH AGENCY LLC.

Practice address

3828 Meramec St
Saint Louis, MO 63116-4470

Phone

(314) 369-2056

Fax

(314) 353-3882

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Neliie Tsimerman

Title

Owner Administrator

Phone

(314) 369-2056

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241740800000",
    "number": "1558487124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3828 MERAMEC ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164470",
            "telephone_number": "314-369-2056",
            "fax_number": "314-353-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 MERAMEC ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164470",
            "telephone_number": "314-369-2056",
            "fax_number": "314-353-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORUM HOME HEALTH AGENCY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2009-05-08",
        "status": "A",
        "authorized_official_last_name": "TSIMERMAN",
        "authorized_official_first_name": "NELIIE",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "314-369-2056"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "LC6820830",
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MO",
            "license": "814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265863209",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285863205",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Fortney, LCSW, CCM
• John Paul Fortney Sr., M.D.
• Ashleigh Fortschneider, PA-C
• Vincent P. Fortunato, MD
• Lisandro Roberto Fortuny
• Forward Function Therapy LLC
• Leslie E Foss, ACNP
• Alisha Fossett
• Angie Earhart Foster, M.D.
• Camille Nicole Foster

• Adult Day Care Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Day Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; 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.