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General NPI Number Information
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NPI Number | 1376763292
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Entity Type | Organization
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Legal Business Name | RELIABLE HOME CARE INC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1106 LAGUILLE CT
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City | ROLLA
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State | MO
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Zip | 65401-3440
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Country | US
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Telephone | 537-341-1103
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Fax |
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Provider Business Mailing Address
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Address Line | 509 E CHESTNUT ST
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City | DESLOGE
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State | MO
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Zip | 63601-3307
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Country | US
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Telephone | 573-431-1010
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Fax | 573-431-1013
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Authorized Official
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Title or Position | PREISDENT
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Name | MR. JACKIE LEE TUCKER JR.
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Credential |
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Telephone | 573-431-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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