Provider Demographics
NPI:1376763292
Name:RELIABLE HOME CARE INC
Entity Type:Organization
Organization Name:RELIABLE HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREISDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:573-431-1010
Mailing Address - Street 1:509 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:DESLOGE
Mailing Address - State:MO
Mailing Address - Zip Code:63601-3307
Mailing Address - Country:US
Mailing Address - Phone:573-431-1010
Mailing Address - Fax:573-431-1013
Practice Address - Street 1:1106 LAGUILLE CT
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-3440
Practice Address - Country:US
Practice Address - Phone:537-341-1103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities