Healthcare Provider Details

I. General information

NPI: 1972705507
Provider Name (Legal Business Name): HEARTHSTONE ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 SW 15TH ST
BLUE SPRINGS MO
64015-4191
US

IV. Provider business mailing address

808 SW 15TH ST
BLUE SPRINGS MO
64015-4191
US

V. Phone/Fax

Practice location:
  • Phone: 816-220-3343
  • Fax: 816-220-3353
Mailing address:
  • Phone: 816-220-3343
  • Fax: 816-220-3353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number638
License Number StateMO

VIII. Authorized Official

Name: MRS. VIRGINIA MARLENE REHMSMEYER
Title or Position: OWNER
Credential:
Phone: 816-220-3343