Healthcare Provider Details

I. General information

NPI: 1568455418
Provider Name (Legal Business Name): REGIONAL HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 W COMMERCIAL ST
KAHOKA MO
63445-1413
US

IV. Provider business mailing address

235 W COMMERCIAL ST
KAHOKA MO
63445-1413
US

V. Phone/Fax

Practice location:
  • Phone: 660-727-2365
  • Fax: 660-727-2620
Mailing address:
  • Phone: 660-727-2365
  • Fax: 660-727-2620

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: JENNIFER DAWSON
Title or Position: OWNER
Credential:
Phone: 319-835-9035