Provider Demographics
NPI:1437981305
Name:NINEVEH HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:NINEVEH HOME HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:DEPRIEST
Authorized Official - Last Name:LYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-494-4203
Mailing Address - Street 1:464 COVENTRY TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-5134
Mailing Address - Country:US
Mailing Address - Phone:314-494-4203
Mailing Address - Fax:
Practice Address - Street 1:920 1ST CAPITOL DR STE 203&204
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2991
Practice Address - Country:US
Practice Address - Phone:314-494-4203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based