Provider Demographics
NPI:1538601984
Name:PREFERRED HOME CARE LLC
Entity type:Organization
Organization Name:PREFERRED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:GABRIELLE
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-738-3973
Mailing Address - Street 1:100 RUE SAINT FRANCOIS ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-5132
Mailing Address - Country:US
Mailing Address - Phone:314-738-3973
Mailing Address - Fax:
Practice Address - Street 1:100 RUE SAINT FRANCOIS ST
Practice Address - Street 2:STE 201
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-5134
Practice Address - Country:US
Practice Address - Phone:314-738-3973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health