MEDICARE: AT HOME INDEPENDENCE QUALITY HOME CARE,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
1	251E00000X	Home Health Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1467085811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT HOME INDEPENDENCE QUALITY HOME CARE,LLC

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	:	CEO/EXECUTIVE DIRECTOR
Name	:	KIMBERLY S DELGADO
Credential	:	PSY D, LPC
Telephone Number	:	417-448-8960

Provider Enumeration Date	:	02/13/2020
Last Update Date	:	01/23/2026

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