Individual provider · NPI-1

Rose M Boothe

Homemaker · Saint Louis, MO

NPI number1285990119
StatusActive
Last updated in NPPESJun 4, 2024

Details

NPI
1285990119
Entity type
Individual (NPI-1)
Name
Rose M Boothe
Sex
Female
Sole proprietor
No
Enumeration date
Apr 4, 2012
Certification date
Jun 4, 2024
Last updated
Jun 4, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
376J00000X Homemaker01151547MOYes
3747P1801X Technician, Personal Care Attendant01151547MO

Practice location

8650 Moran Pl Ace
Saint Louis, MO 63114-4437

Phone 314-397-0905 · Fax 314-222-3394

Mailing address

8650 Moran Pl
Saint Louis, MO 63114-4437

Phone 314-397-0905 · Fax 314-222-3394

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Homemaker providers in Saint Louis, MO