Advantage Consumer Directed Services, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ADVANTAGE CONSUMER DIRECTED SERVICES, LLC

Practice address

11796 Westline Industrial Dr
Saint Louis, MO 63146-3402

Phone

(314) 282-2957

Fax

(314) 282-2967

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Bosen P John

Title

Ceo

Phone

(314) 282-2957

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1902028772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11796 WESTLINE INDUSTRIAL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463402",
            "telephone_number": "314-282-2957",
            "fax_number": "314-282-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11796 WESTLINE INDUSTRIAL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463402",
            "telephone_number": "314-282-2957",
            "fax_number": "314-282-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE CONSUMER DIRECTED SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "BOSEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-282-2957",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008753",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266270008",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286270004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Saint Louis, MO
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.