NPI 1164971933 · live from the CMS NPI Registry
417 Home Care LLC
In Home Supportive Care in Ozark, MO. National Provider Identifier 1164971933, active.
NPI record
| NPI | 1164971933 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | In Home Supportive Care 253Z00000X |
| Practice location | 850 N 25th St, Ozark, MO 65721 |
| Practice phone | 417-581-1234 |
| Enumerated | September 22, 2016 |
| Last updated | March 7, 2023 |
| Authorized official | John Ray, Ceo |
| Other names | Haven Home Care |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chore Provider | 372500000X | — |
| Adult Companion | 372600000X | — |
| Technician, Attendant Care Provider | 3747A0650X | — |
| Technician, Personal Care Attendant | 3747P1801X | — |
| Home Health Aide | 374U00000X | — |
| Homemaker | 376J00000X | — |
| Nurse's Aide | 376K00000X | — |
| In Home Supportive Care primary | 253Z00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.