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PHOENIX HOME CARE LLC NPI 1003382680


NPI Information

NPI: 1003382680
Provider Name: PHOENIX HOME CARE, LLC

Doing Business As: PHOENIX HOME CARE AND HOSPICE

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
3033 S KANSAS EXPY
SPRINGFIELD, MO
ZIP 65807
Phone: (417) 881-7442
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PHOENIX HOME CARE, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Springfield, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. PHOENIX HOME CARE, LLC NPI is 1003382680. The provider is registered as an organization entity type.
The provider Is Doing Business As Phoenix Home Care And Hospice.

The provider's business location address is:

3033 S KANSAS EXPY
SPRINGFIELD, MO
ZIP 65807-969
Phone: (417) 881-7442
Fax: (417) 889-7442

The provider's authorized official is George Scott Herman .
The authorized official title is President & Secretary and has the following contact phone number (417) 838-3000.

The enumeration date for this NPI number is 10/22/2018 and was last updated on 12/13/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesMISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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