Provider Demographics
NPI:1558736207
Name:ON MY OWN, INC.
Entity Type:Organization
Organization Name:ON MY OWN, INC.
Other - Org Name:ON MY OWN IN HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-667-7007
Mailing Address - Street 1:428 E HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-1019
Mailing Address - Country:US
Mailing Address - Phone:417-667-7007
Mailing Address - Fax:417-667-6262
Practice Address - Street 1:428 E HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-1019
Practice Address - Country:US
Practice Address - Phone:417-667-7007
Practice Address - Fax:417-667-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOM286212402Medicaid
MO1558736207Medicaid
MO1841322617Medicaid