Provider Demographics
NPI:1689798845
Name:CITIZENS MEMORIAL HEALTHCARE FOUNDATION HOMEMAKER PLUS
Entity Type:Organization
Organization Name:CITIZENS MEMORIAL HEALTHCARE FOUNDATION HOMEMAKER PLUS
Other - Org Name:HOMEMAKER PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PIPPINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-326-4357
Mailing Address - Street 1:1500 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-3011
Mailing Address - Country:US
Mailing Address - Phone:417-326-4357
Mailing Address - Fax:417-326-6943
Practice Address - Street 1:113 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-1621
Practice Address - Country:US
Practice Address - Phone:417-326-4357
Practice Address - Fax:417-326-6943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty