Healthcare Provider Details

I. General information

NPI: 1174189161
Provider Name (Legal Business Name): SHOW-ME HEALTH INNOVATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10430 TINDALL RD
CADET MO
63630-8283
US

IV. Provider business mailing address

10430 TINDALL RD
CADET MO
63630-8283
US

V. Phone/Fax

Practice location:
  • Phone: 573-701-0651
  • Fax:
Mailing address:
  • Phone: 573-701-0651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LINDA DECLUE
Title or Position: MANAGER
Credential:
Phone: 573-438-7778