Provider Demographics
NPI:1558848895
Name:PLEASANT NURSE HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:PLEASANT NURSE HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PORTLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:PLEASANT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-743-7828
Mailing Address - Street 1:5854 DELMAR BLVD.
Mailing Address - Street 2:SUITE B.
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-2308
Mailing Address - Country:US
Mailing Address - Phone:314-696-8526
Mailing Address - Fax:314-696-8525
Practice Address - Street 1:5854 DELMAR BLVD.
Practice Address - Street 2:SUITE B.
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-2308
Practice Address - Country:US
Practice Address - Phone:314-696-8526
Practice Address - Fax:314-696-8525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC001590238251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health