1053799338 NPI number — KEEPING GOOD COMPANY SENIOR CARE AT HOME, LLC

Table of content: (NPI 1053799338)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053799338 NPI number — KEEPING GOOD COMPANY SENIOR CARE AT HOME, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KEEPING GOOD COMPANY SENIOR CARE AT HOME, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053799338
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7771
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65205-7771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-445-0532
Provider Business Mailing Address Fax Number:
573-445-0532

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7000 S SABINE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65203-9347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-445-0532
Provider Business Practice Location Address Fax Number:
573-445-0532
Provider Enumeration Date:
05/07/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SCHILKE
Authorized Official First Name:
LORRAINE
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
OWNER, MANAGER
Authorized Official Telephone Number:
573-864-6490

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  LC1337284 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com