Healthcare Provider Details

I. General information

NPI: 1992163083
Provider Name (Legal Business Name): CHANCES OF HOPE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 02/29/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 S. MADSION
WEBB CITY MO
64870
US

IV. Provider business mailing address

27 S. MADSION
WEBB CITY MO
64870
US

V. Phone/Fax

Practice location:
  • Phone: 417-717-5117
  • Fax: 417-717-5118
Mailing address:
  • Phone:
  • Fax: 417-717-5118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAD BROOKS
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 417-540-4427