Healthcare Provider Details

I. General information

NPI: 1922202209
Provider Name (Legal Business Name): HEALTHY HOME & FAMILY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W HARRISON ST
FARMINGTON MO
63640-2510
US

IV. Provider business mailing address

210 W HARRISON ST
FARMINGTON MO
63640-2510
US

V. Phone/Fax

Practice location:
  • Phone: 573-760-0709
  • Fax: 573-760-0124
Mailing address:
  • Phone: 573-760-0709
  • Fax: 573-760-0124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number141590
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. GABRIEL CRAWFORD
Title or Position: PRESIDENT
Credential: PMHNP
Phone: 573-330-6468