Provider Demographics
NPI:1851323703
Name:HOME HEALTH NETWORK SPECIALISTS, INC
Entity Type:Organization
Organization Name:HOME HEALTH NETWORK SPECIALISTS, INC
Other - Org Name:HOME ADVANTAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-471-1276
Mailing Address - Street 1:PO BOX 1210
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-1210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:808 HUNTER
Practice Address - Street 2:SUITE 3
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801
Practice Address - Country:US
Practice Address - Phone:573-472-4165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00010727251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO587743709Medicaid
MO433-16HHOtherSTATE LICENSE
267460Medicare ID - Type Unspecified