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General NPI Number Information
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NPI Number | 1508314907
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Entity Type | Organization
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Legal Business Name | FAMILY MATTERS CDS LLC
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 413 MAIN STREET
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City | NEW MADRID
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State | MO
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Zip | 63869
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Country | US
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Telephone | 573-748-7696
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Fax | 573-748-4058
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Provider Business Mailing Address
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Address Line | 413 MAIN STREET
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City | NEW MADRID
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State | MO
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Zip | 63869
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Country | US
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Telephone | 573-748-7696
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Fax | 573-748-4058
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN LYNN
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Credential |
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Telephone | 870-623-7769
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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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