Provider Demographics
NPI:1508080698
Name:HEALTHY HOME & FAMILY, INC.
Entity Type:Organization
Organization Name:HEALTHY HOME & FAMILY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:STOCKSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:573-760-0709
Mailing Address - Street 1:210 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-2510
Mailing Address - Country:US
Mailing Address - Phone:573-760-0709
Mailing Address - Fax:573-760-0124
Practice Address - Street 1:1007 SAINTE GENEVIEVE AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1123
Practice Address - Country:US
Practice Address - Phone:573-760-0709
Practice Address - Fax:573-760-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO855673307Medicaid