Provider Demographics
NPI:1760277529
Name:EDIFY HOME HEALTH SERVICE
Entity type:Organization
Organization Name:EDIFY HOME HEALTH SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-278-4645
Mailing Address - Street 1:215 ROLLING ROCK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-5582
Mailing Address - Country:US
Mailing Address - Phone:765-278-4645
Mailing Address - Fax:
Practice Address - Street 1:215 ROLLING ROCK CREEK DR
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-5582
Practice Address - Country:US
Practice Address - Phone:765-278-4645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health