Provider Demographics
NPI:1053459073
Name:WESTWOOD HOME CARE
Entity Type:Organization
Organization Name:WESTWOOD HOME CARE
Other - Org Name:WILLOW HEALTH CARE INC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICARE BILLING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-469-3152
Mailing Address - Street 1:2642 STATE ROUTE 76
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65793-8254
Mailing Address - Country:US
Mailing Address - Phone:417-469-3152
Mailing Address - Fax:417-469-5304
Practice Address - Street 1:2642 STATE ROUTE 76
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65793-8254
Practice Address - Country:US
Practice Address - Phone:417-469-3152
Practice Address - Fax:417-469-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO261474100Medicaid