Provider Demographics
NPI:1487085957
Name:FHHS HHA MO LLC
Entity type:Organization
Organization Name:FHHS HHA MO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-560-8953
Mailing Address - Street 1:2299 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-7341
Mailing Address - Country:US
Mailing Address - Phone:636-625-6191
Mailing Address - Fax:636-625-6194
Practice Address - Street 1:2299 TECHNOLOGY DR
Practice Address - Street 2:SUITE 225
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-7341
Practice Address - Country:US
Practice Address - Phone:636-625-6191
Practice Address - Fax:636-625-6194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health