Provider Demographics
NPI:1689826448
Name:NURSING EXECUTIVES HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:NURSING EXECUTIVES HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-395-7780
Mailing Address - Street 1:11551 PHILMAR LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-1721
Mailing Address - Country:US
Mailing Address - Phone:314-395-7780
Mailing Address - Fax:314-395-4317
Practice Address - Street 1:11551 PHILMAR LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138-1721
Practice Address - Country:US
Practice Address - Phone:314-395-7780
Practice Address - Fax:314-395-4317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC0831239251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health