MEDICARE: HOME LIGHT 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	251J00000X	Nursing Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1629958319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME LIGHT CARE LLC

Provider Business Mailing Address
First Line	:	3232 BELLEFONTAINE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64128-1949
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3232 BELLEFONTAINE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64128-1949
Country	:	US
Telephone Number	:	816-562-4472
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEXIS HENDERSON
Credential	:
Telephone Number	:	816-562-4472

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	09/04/2025

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Directions to “HOME LIGHT CARE LLC ” Practice Location

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