Healthcare Provider Details

I. General information

NPI: 1881753093
Provider Name (Legal Business Name): REGIONAL PRIVATE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 1 BOX 16B
KAHOKA MO
63445-9650
US

IV. Provider business mailing address

RR 1 BOX 16B
KAHOKA MO
63445-9650
US

V. Phone/Fax

Practice location:
  • Phone: 660-727-9040
  • Fax: 660-727-2620
Mailing address:
  • Phone: 660-727-9040
  • Fax: 660-727-2620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JENNIFER DAWSON
Title or Position: OWNER
Credential:
Phone: 13198353933