Provider Demographics
NPI:1356631253
Name:BRENDA'S ASSURED HOME CARE LLC
Entity Type:Organization
Organization Name:BRENDA'S ASSURED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DESIGNATED MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-536-5416
Mailing Address - Street 1:1006 CONEFLOWER STREET
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089-9066
Mailing Address - Country:US
Mailing Address - Phone:816-536-5416
Mailing Address - Fax:816-532-8037
Practice Address - Street 1:1006 CONEFLOWER ST
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MO
Practice Address - Zip Code:64089-9066
Practice Address - Country:US
Practice Address - Phone:816-536-5416
Practice Address - Fax:816-532-8037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care