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Organization
COMMUNITY WIDE IN HOME LLC
Active
Organization
COMMUNITY WIDE IN HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY DEAN DAVIS (PRESIDENT CEO)
(573) 448-3297
Entity
Organization
Contact information
Practice address
106 LUNBECK AVE, GIDEON, MO 63848-9276
(573) 448-3297
(573) 448-3297
Mailing address
106 LUNBECK AVE, GIDEON, MO 63848-9276
(573) 448-3297
(573) 448-3297
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
02/11/2008
Last updated
02/11/2008
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