Healthcare Provider Details

I. General information

NPI: 1912579533
Provider Name (Legal Business Name): MIGHTY HANDS HOME AND HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3239 GARFIELD AVE APT 2S
KANSAS CITY MO
64109-2009
US

IV. Provider business mailing address

3239 GARFIELD AVE APT 2S
KANSAS CITY MO
64109-2009
US

V. Phone/Fax

Practice location:
  • Phone: 816-469-1981
  • Fax:
Mailing address:
  • Phone: 816-469-1981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: TALISA A NELSON
Title or Position: OWNER
Credential: LPN
Phone: 816-469-1981