Healthcare Provider Details

I. General information

NPI: 1982429858
Provider Name (Legal Business Name): PUZZLE PIECES OF HOPE HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8670 N WYANDOTTE ST APT 417
KANSAS CITY MO
64155-2767
US

IV. Provider business mailing address

8670 N WYANDOTTE ST APT 417
KANSAS CITY MO
64155-2767
US

V. Phone/Fax

Practice location:
  • Phone: 314-477-7480
  • Fax:
Mailing address:
  • Phone: 314-477-7480
  • 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: REVENDA SHERA BECKLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 314-477-7480