Healthcare Provider Details

I. General information

NPI: 1013807759
Provider Name (Legal Business Name): WOUND CARE AT HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 W 32ND ST BUILDING C SUITE 221
JOPLIN MO
64804-6017
US

IV. Provider business mailing address

1801 W 32ND ST STE 221
JOPLIN MO
64804-1528
US

V. Phone/Fax

Practice location:
  • Phone: 417-229-7261
  • Fax:
Mailing address:
  • Phone: 417-229-7261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIEL GRANT REAVIS
Title or Position: OWNER / MANAGING MEMBER
Credential: RN
Phone: 417-229-7261