Active NPI
Alix Home Healthcare Illinois LLC
- In Home Supportive Care Agency
- East Saint Louis, IL
National Provider Identifier
1831008317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Legal business name
- ALIX HOME HEALTHCARE ILLINOIS LLC
- Practice address
- 2415 State St
East Saint Louis, IL 62205-2320 - Phone
- (618) 515-3043
- NPI assigned
- Sep 2, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Stacey Blackmon
- Title
- Owner
- Phone
- (314) 402-3992
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
2415 State St
East Saint Louis, IL 62205-2320
Mailing address
2415 State St
East Saint Louis, IL 62205-2320
Phone (618) 515-3043
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6592163 | Medicaid | IL |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788307200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788307200000",
"number": "1831008317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2415 STATE ST",
"city": "EAST SAINT LOUIS",
"state": "IL",
"postal_code": "622052320",
"telephone_number": "618-515-3043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 STATE ST",
"city": "EAST SAINT LOUIS",
"state": "IL",
"postal_code": "622052320",
"telephone_number": "618-515-3043"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALIX HOME HEALTHCARE ILLINOIS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-02",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A",
"authorized_official_last_name": "BLACKMON",
"authorized_official_first_name": "STACEY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "314-402-3992",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6592163",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Saint Louis, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.