Provider Demographics
NPI:1538376306
Name:MISSOURI PROFESSIONAL STAFFING SERVICE HOME HEALTH INC
Entity type:Organization
Organization Name:MISSOURI PROFESSIONAL STAFFING SERVICE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:HILTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-567-0073
Mailing Address - Street 1:680 CRAIG RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7120
Mailing Address - Country:US
Mailing Address - Phone:314-567-0073
Mailing Address - Fax:314-567-1940
Practice Address - Street 1:680 CRAIG RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7120
Practice Address - Country:US
Practice Address - Phone:314-567-0073
Practice Address - Fax:314-567-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0002160Medicaid