MEDICARE: AT HOME INDEPENDENCE IN HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	385H00000X	Respite Care
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1215428735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT HOME INDEPENDENCE IN HOME CARE

Provider Business Mailing Address
First Line	:	216 W CHERRY ST
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772-3362
Country	:	US
Telephone Number	:	417-448-8960
Fax Number	:	417-448-6555

Provider Business Practice Location Address
First Line	:	216 W CHERRY ST
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772-3362
Country	:	US
Telephone Number	:	417-448-8960
Fax Number	:	417-448-6555

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. KIMBERLY SUE DELGADO
Credential	:	PSY D., LPC
Telephone Number	:	417-448-8960

Provider Enumeration Date	:	05/21/2018
Last Update Date	:	11/17/2020

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Directions to “AT HOME INDEPENDENCE IN HOME CARE ” Practice Location

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