Provider Demographics
NPI:1770299349
Name:CARE COMPANION HEALTH SERVICES IHS LLC
Entity type:Organization
Organization Name:CARE COMPANION HEALTH SERVICES IHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LATONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-276-5672
Mailing Address - Street 1:5494 BROWN RD STE 107
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-1100
Mailing Address - Country:US
Mailing Address - Phone:314-837-8067
Mailing Address - Fax:314-584-2163
Practice Address - Street 1:5494 BROWN RD STE 107
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-1100
Practice Address - Country:US
Practice Address - Phone:314-837-8067
Practice Address - Fax:314-584-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care