Provider Demographics
NPI:1821150343
Name:SERVE LINK HOME CARE, INC.
Entity Type:Organization
Organization Name:SERVE LINK HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KASSIE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:666-359-4218
Mailing Address - Street 1:1510 E. 9TH ST.
Mailing Address - Street 2:P.O. BOX 308
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683
Mailing Address - Country:US
Mailing Address - Phone:660-359-4218
Mailing Address - Fax:660-359-2134
Practice Address - Street 1:1510 E 9TH ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MO
Practice Address - Zip Code:64683-2632
Practice Address - Country:US
Practice Address - Phone:660-359-4218
Practice Address - Fax:660-359-2134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO57-22251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO580620300Medicaid