MEDICARE: PERSONAL CARE SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1447370564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL CARE SERVICES INC.

Provider Business Mailing Address
First Line	:	3325 GHOST HOLLOW ROAD
Second Line	:
City	:	QUINCY
State	:	IL
Zip	:	62305
Country	:	US
Telephone Number	:	217-228-9268
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 2ND ST
Second Line	:
City	:	MONROE CITY
State	:	MO
Zip	:	63456-1322
Country	:	US
Telephone Number	:	573-735-4430
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PAUL JOHN HOLTSCHLAG
Credential	:	B.S.
Telephone Number	:	217-228-9268

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	08/22/2020

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