1003249509 NPI number — EXCEPTIONAL LOVING HOME HEALTHCARE

Table of content: MARIA ELENA SANTIAGO LCSW (NPI 1831325497)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003249509 NPI number — EXCEPTIONAL LOVING HOME HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EXCEPTIONAL LOVING HOME HEALTHCARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003249509
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7914 COOL VALLEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63121-2023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-810-2501
Provider Business Mailing Address Fax Number:
314-521-8097

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1515 N WARSON RD
Provider Second Line Business Practice Location Address:
SUITE 113E
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63132-1111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-810-2501
Provider Business Practice Location Address Fax Number:
314-521-8097
Provider Enumeration Date:
08/20/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LEE
Authorized Official First Name:
AMY
Authorized Official Middle Name:
R
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
314-810-2501

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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