Provider Demographics
NPI:1093492084
Name:TERRAGENESIS HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:TERRAGENESIS HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:BEE
Authorized Official - Suffix:
Authorized Official - Credentials:DO, DC, MS, FACOI
Authorized Official - Phone:405-641-2074
Mailing Address - Street 1:411 AVALON CHASE DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-7802
Mailing Address - Country:US
Mailing Address - Phone:405-641-2074
Mailing Address - Fax:
Practice Address - Street 1:411 AVALON CHASE DR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-7802
Practice Address - Country:US
Practice Address - Phone:405-641-2074
Practice Address - Fax:888-394-2144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care