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General NPI Number Information
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NPI Number | 1134712599
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Entity Type | Organization
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Legal Business Name | MISSOURI AT HOME, LLC.
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 2011 CHAPEL PLAZA CT STE 11
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City | COLUMBIA
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State | MO
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Zip | 65203-6398
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Country | US
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Telephone | 573-445-6340
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Fax | 314-714-6181
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Provider Business Mailing Address
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Address Line | 2011 CHAPEL PLAZA CT STE 11
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City | COLUMBIA
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State | MO
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Zip | 65203-6398
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Country | US
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Telephone | 573-445-6340
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Fax | 314-714-6181
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Authorized Official
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Title or Position | OWNER
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Name | MR. SHAWN KRATZ
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Credential |
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Telephone | 314-221-9324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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