Provider Demographics
NPI:1508506106
Name:CHRISTIAN HOME CARE LLC
Entity Type:Organization
Organization Name:CHRISTIAN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:HEFLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:417-733-4162
Mailing Address - Street 1:311 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:MO
Mailing Address - Zip Code:65767-9101
Mailing Address - Country:US
Mailing Address - Phone:417-733-4162
Mailing Address - Fax:
Practice Address - Street 1:311 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:MO
Practice Address - Zip Code:65767-9101
Practice Address - Country:US
Practice Address - Phone:417-733-4162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIAN HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility