Provider Demographics
NPI:1437852597
Name:WELLNESS IN HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:WELLNESS IN HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ORANIZER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DECKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-270-0349
Mailing Address - Street 1:238 PRIVATE ROAD 63-106
Mailing Address - Street 2:
Mailing Address - City:THAYER
Mailing Address - State:MO
Mailing Address - Zip Code:65791-8721
Mailing Address - Country:US
Mailing Address - Phone:417-270-0349
Mailing Address - Fax:
Practice Address - Street 1:238 PRIVATE ROAD 63-106
Practice Address - Street 2:
Practice Address - City:THAYER
Practice Address - State:MO
Practice Address - Zip Code:65791-8721
Practice Address - Country:US
Practice Address - Phone:417-270-0349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care