MEDICARE: WALKENHORST SENIOR 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	:	1821659442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALKENHORST SENIOR CARE, LLC

Provider Business Mailing Address
First Line	:	1615 HERITAGE HILLS DR
Second Line	:
City	:	WASHINGTON
State	:	MO
Zip	:	63090-4619
Country	:	US
Telephone Number	:	636-900-9110
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 HERITAGE HILLS DR
Second Line	:
City	:	WASHINGTON
State	:	MO
Zip	:	63090-4619
Country	:	US
Telephone Number	:	636-900-9110
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEBBE WALKENHORST
Credential	:
Telephone Number	:	636-900-9110

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	06/25/2019

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