NPIMap

Organization Active NPI

Cooperative Home Care, Inc.

  • Nursing Care Agency
  • Fairview Heights, IL
National Provider Identifier
1619551215
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
COOPERATIVE HOME CARE, INC.
Practice address
107 Lanaghan Dr
Fairview Heights, IL 62208-2730
Phone
(618) 394-5681
Fax
(314) 735-4177
NPI assigned
May 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Authorized official

Name
Mitch I Waks
Title
Ceo & Owner
Phone
(314) 772-8585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X Primary

Addresses

Primary practice location

107 Lanaghan Dr
Fairview Heights, IL 62208-2730

Mailing address

1924 Marconi Ave
Saint Louis, MO 63110-3038
Phone (314) 772-8585

National Provider Directory

National Provider Directory
Tax ID family
Cooperative Home Care7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1619551215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 MARCONI AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103038",
            "telephone_number": "314-772-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 LANAGHAN DR",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082730",
            "telephone_number": "618-394-5681",
            "fax_number": "314-735-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPERATIVE HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "WAKS",
        "authorized_official_first_name": "MITCH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO & OWNER",
        "authorized_official_telephone_number": "314-772-8585"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.