Organization · Type 2 NPI

Phoenix Home Care, LLC

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Springfield, MO

NPI number 1003382680 Active

Practice location

3033 S Kansas Expy
Springfield, MO 65807-5969

Call (417) 881-7442 Map

Fax (417) 889-7442

Mailing address

3450 N. Rock Rd., #213, Attn: Debra Mullen
Wichita, KS 67226-1352

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	None listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Another provider at this address

Lisa Jo Moore, NP-CNurse Practitioner Springfield, MO NPI 1033718903

Other intellectual and/or developmental disabilities community based residential treatment facility providers in Springfield

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NPI record

NPI: 1003382680
Entity type: Organization (Type 2)
Issued: Oct 22, 2018
Last updated: Dec 13, 2021
Status: Active

Other names

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Phoenix Home Care and Hospice · doing business as
Phoenix Home Care and Hospice · doing business as

Authorized official

George Scott Herman
President & Secretary
(417) 838-3000

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003382680

Phoenix Home Care, LLC's National Provider Identifier is 1003382680, issued on Oct 22, 2018. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Springfield, MO. The record was last updated on Dec 13, 2021.