MEDICARE: COURAGEOUS 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1821533399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COURAGEOUS HOME CARE, LLC

Provider Business Mailing Address
First Line	:	300 SW NOEL ST
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64063-3810
Country	:	US
Telephone Number	:	816-699-2352
Fax Number	:	816-776-4389

Provider Business Practice Location Address
First Line	:	300 SW NOEL ST
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64063-3810
Country	:	US
Telephone Number	:	816-699-2352
Fax Number	:	816-776-4389

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MUSUDEEN HARRELL
Credential	:
Telephone Number	:	816-699-2352

Provider Enumeration Date	:	12/19/2016
Last Update Date	:	09/13/2023

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