Provider Demographics
NPI:1487098372
Name:SEMO REGIONAL HOME CARE, LLC
Entity type:Organization
Organization Name:SEMO REGIONAL HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:DELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-614-2590
Mailing Address - Street 1:129 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MO
Mailing Address - Zip Code:63863-2109
Mailing Address - Country:US
Mailing Address - Phone:573-276-2294
Mailing Address - Fax:573-276-2295
Practice Address - Street 1:129 S MADISON ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MO
Practice Address - Zip Code:63863-2109
Practice Address - Country:US
Practice Address - Phone:573-276-2294
Practice Address - Fax:573-276-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health