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NPI Code Detail

MEDICARE: BOOTHEEL IN-HOME CARE SERVICES, LLC

MEDICARE: BOOTHEEL IN-HOME CARE SERVICES, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse
2164W00000XLicensed Practical Nurse
3251J00000XNursing Care Agency
43747P1801XPersonal Care Attendant
5376J00000XHomemaker
6376K00000XNurse's Aide
7253Z00000XIn Home Supportive Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285677930
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOOTHEEL IN-HOME CARE SERVICES, LLC
Provider Business Mailing Address
First Line : 311 MAIN ST
Second Line :
City : NEW MADRID
State : MO
Zip : 63869-1942
Country : US
Telephone Number : 573-748-5905
Fax Number : 573-748-5795
Provider Business Practice Location Address
First Line : 311 MAIN ST
Second Line :
City : NEW MADRID
State : MO
Zip : 63869-1942
Country : US
Telephone Number : 573-748-5905
Fax Number : 573-748-5795
Authorized Official
Title or Position : PRESIDENT
Name : MRS. KATHEY G VERBECK
Credential :
Telephone Number : 618-616-7732
Provider Enumeration Date : 06/13/2006
Last Update Date : 06/01/2020

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Directions to “BOOTHEEL IN-HOME CARE SERVICES, LLC ” Practice Location

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