Mrs Octavia Inhome Health Care Service

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MRS OCTAVIA INHOME HEALTH CARE SERVICE

Practice address

1516 Goodfellow Blvd Apt A1516
Saint Louis, MO 63112-3828

Phone

(314) 652-4209

Fax

(314) 226-4500

NPI assigned

Jun 20, 2023

Organization subpart

No

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) 260-9106

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1588349245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 GOODFELLOW BLVD APT A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123828",
            "telephone_number": "314-260-9106",
            "fax_number": "557-467-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 GOODFELLOW BLVD APT A1516",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123828",
            "telephone_number": "314-652-4209",
            "fax_number": "314-226-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRS OCTAVIA INHOME HEALTH CARE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-260-9106"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margo Mriscin
• Paul Thomas Mrotek, PA-C
• Joseph Daniel Mroz, D.D.S.
• Mrs Octavia Home Health Care LLC
• Mrs Octavia Home Health Care LLC
• MRT Medical Group.PC (County Medical Specialists)
• Petya Gancheva Mruckovski, RDH
• Gabriel Msengi, PHARMD.
• MTR, LLC
• Roeshelle Renne Mu'Min, LCSW

• In Home Supportive Care Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• In Home Supportive Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.