Provider Demographics
NPI:1164601563
Name:PACE HOME SERVICES LLC
Entity Type:Organization
Organization Name:PACE HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:MARILYN
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-356-2005
Mailing Address - Street 1:9812 E 87TH ST
Mailing Address - Street 2:SUITE #D
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64138-4703
Mailing Address - Country:US
Mailing Address - Phone:816-356-2005
Mailing Address - Fax:
Practice Address - Street 1:8409 OLIVE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-2320
Practice Address - Country:US
Practice Address - Phone:816-523-0878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities