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General NPI Number Information
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NPI Number | 1023204880
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Entity Type | Organization
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Legal Business Name | AGING MADE EASY, LLC
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 126 N JEFFERSON ST
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City | SAINT JAMES
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State | MO
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Zip | 65559-1918
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Country | US
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Telephone | 573-265-6004
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Fax |
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Provider Business Mailing Address
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Address Line | 126 N JEFFERSON ST
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City | SAINT JAMES
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State | MO
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Zip | 65559-1918
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Country | US
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Telephone | 573-265-6004
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MRS. SANDRA KAY JOHNSON
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Credential |
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Telephone | 573-263-1487
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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 | LC0796509
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License Number State | MO
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