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General NPI Number Information
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NPI Number | 1013807759
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Entity Type | Organization
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Legal Business Name | WOUND CARE AT HOME, LLC
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Dates
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Enumeration Date | 07/05/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1801 W 32ND ST BUILDING C SUITE 221
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City | JOPLIN
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State | MO
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Zip | 64804-6017
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Country | US
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Telephone | 417-229-7261
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 W 32ND ST STE 221
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City | JOPLIN
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State | MO
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Zip | 64804-1528
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Country | US
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Telephone | 417-229-7261
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Fax |
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Authorized Official
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Title or Position | OWNER / MANAGING MEMBER
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Name | DANIEL GRANT REAVIS
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Credential | RN
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Telephone | 417-229-7261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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