Healthcare Provider Details

I. General information

NPI: 1659445856
Provider Name (Legal Business Name): KETCH CARES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
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

Practice location:
  • Phone: 417-866-1559
  • Fax: 417-866-3846
Mailing address:
  • Phone: 417-866-1559
  • Fax: 417-720-1597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number0001732
License Number StateMO

VIII. Authorized Official

Name: CHRISTOPHER UPTON
Title or Position: DIRECTOR
Credential:
Phone: 417-866-1559