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Contact Information

AGING WELL HEALTH CARE, LLC
7212 BALSON AVE
SAINT LOUIS, MO63130-3001
 Phone: 314-726-5600
 Fax: 314-754-9317
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
 

Adult Day Care

261QA0600X
 

Nursing Care

251J00000X
 

Occupational Medicine

261QX0100X
 

Physical Therapy

261QP2000X
 

Respite Care

385H00000X
Indicates primary specialty

NPI Profile & details for AGING WELL HEALTH CARE, LLC

NPI Number 1215936588
LBN Legal business name AGING WELL HEALTH CARE, LLC
Authorized official IRINA BURSAK - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/19/2005
Last updated 09/20/2010 - About 16 years ago
Identifiers
IL License # 1010588
MO License # 265855403
MO License # 266633
MO License # 285855409
MO License # 609
MO License # 755
MO Medicaid 265855403
MO Medicaid 285855409
MO Medicaid 295855407
MO Medicaid 575855408
MO Medicaid 585855406
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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