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General NPI Number Information
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NPI Number | 1306324678
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Entity Type | Organization
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Legal Business Name | MUSKETEER IN-HOME CARE LLC
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 201 N FOREST AVE STE 223A
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City | INDEPENDENCE
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State | MO
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Zip | 64050-2696
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Country | US
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Telephone | 816-419-3036
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Fax | 816-678-0632
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Provider Business Mailing Address
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Address Line | 201 N FOREST AVE STE 223A
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City | INDEPENDENCE
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State | MO
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Zip | 64050-2696
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Country | US
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Telephone | 816-419-3036
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Fax | 816-678-0632
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Authorized Official
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Title or Position | PRESIDENT
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Name | SARA L SMITH
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Credential |
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Telephone | 816-419-3036
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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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