Provider Demographics
NPI:1861682171
Name:MONROE COUNTY HEALTH DEPARTMENT & HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:MONROE COUNTY HEALTH DEPARTMENT & HOME HEALTH AGENCY
Other - Org Name:MONROE COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATORS
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:660-327-4653
Mailing Address - Street 1:310 N. MARKET ST.
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:MO
Mailing Address - Zip Code:65275
Mailing Address - Country:US
Mailing Address - Phone:660-327-4653
Mailing Address - Fax:660-327-4533
Practice Address - Street 1:310 N. MARKET ST.
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:MO
Practice Address - Zip Code:65275
Practice Address - Country:US
Practice Address - Phone:660-327-4653
Practice Address - Fax:660-327-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO121-23251E00000X
251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO512059007Medicaid
MO512059007Medicaid