Provider Demographics
NPI:1447826763
Name:1ST ALLY IN HOME SERVICES, LLC
Entity type:Organization
Organization Name:1ST ALLY IN HOME SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TENIESHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-833-3661
Mailing Address - Street 1:3616 UPTON ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-4037
Mailing Address - Country:US
Mailing Address - Phone:314-833-3661
Mailing Address - Fax:314-228-0134
Practice Address - Street 1:3616 UPTON ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-4037
Practice Address - Country:US
Practice Address - Phone:314-833-3661
Practice Address - Fax:314-228-0134
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1ST ALLY HOME HEALTH SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care