Healthcare Provider Details

I. General information

NPI: 1225999659
Provider Name (Legal Business Name): LAMELOT HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 N FEDERAL DR
COLUMBIA MO
65202-5650
US

IV. Provider business mailing address

2240 N FEDERAL DR
COLUMBIA MO
65202-5650
US

V. Phone/Fax

Practice location:
  • Phone: 210-750-0039
  • Fax:
Mailing address:
  • Phone: 210-750-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GABRIEL BAHATI SEMABWA
Title or Position: OWNER/CEO
Credential:
Phone: 210-750-0039