Healthcare Provider Details
I. General information
NPI: 1598344616
Provider Name (Legal Business Name): ADULT TENDERCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2021
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3729 N STATE HIGHWAY H
SPRINGFIELD MO
65803-7137
US
IV. Provider business mailing address
3729 N STATE HIGHWAY H
SPRINGFIELD MO
65803-7137
US
V. Phone/Fax
- Phone: 417-866-1559
- Fax: 417-720-1597
- Phone: 417-866-1559
- Fax: 417-720-1597
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
UPTON
Title or Position: DIRECTOR
Credential:
Phone: 417-866-1559