Healthcare Provider Details

I. General information

NPI: 1164542460
Provider Name (Legal Business Name): RELIABLE HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 LAGUILLE CT
ROLLA MO
65401-3440
US

IV. Provider business mailing address

509 E CHESTNUT ST
DESLOGE MO
63601-3307
US

V. Phone/Fax

Practice location:
  • Phone: 573-341-1103
  • Fax:
Mailing address:
  • Phone: 573-431-3427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. JACKIE LEE TUCKER JR.
Title or Position: PRESIDENT
Credential:
Phone: 573-431-3427