Provider Demographics
NPI:1184826877
Name:BENDER'S HOME CARE, INC.
Entity Type:Organization
Organization Name:BENDER'S HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHOENECK
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:816-233-0171
Mailing Address - Street 1:803 N 36TH ST
Mailing Address - Street 2:STE B
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2978
Mailing Address - Country:US
Mailing Address - Phone:816-233-0171
Mailing Address - Fax:816-233-0712
Practice Address - Street 1:803 N 36TH ST
Practice Address - Street 2:STE B
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2978
Practice Address - Country:US
Practice Address - Phone:816-233-0171
Practice Address - Fax:816-233-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO227-19251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO582209904Medicaid
MO227-19OtherSTATE LICENSE #
MO227-19OtherSTATE LICENSE #