# FC OF MISSOURI INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Intrepid USA Healthcare Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720060304
- **Authorized official:** MR. PAUL D FOSTER (CEO)
- **Authorized official phone:** (214) 445-3750

## Contact information

- **Practice address:** 4305 S. NATIONAL AVE, SPRINGFIELD, MO 65810-2607
- **Practice address phone:** (417) 883-5118
- **Practice address fax:** (417) 883-7436
- **Mailing address:** 4055 VALLEY VIEW LN, 5TH FLOOR, DALLAS, TX 75244-5074
- **Mailing address phone:** (214) 445-3750
- **Mailing address fax:** (214) 445-3902

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 943539809 | MO | — |
| 163W00000X | Registered Nurse | HHA7502 | MO | — |
| 251E00000X | Home Health Agency | 750-7HH | MO | Yes |
| 251E00000X | Home Health Agency | HHA7502 | MO | — |
| 3747P1801X | Personal Care Attendant | 263539801 | MO | — |
| 374U00000X | Home Health Aide | 0002286 | MO | — |
| 376J00000X | Homemaker | 283539807 | MO | — |
| 376J00000X | Homemaker | HHA7502 | MO | — |

## Other

- **Enumeration date:** 11/18/2005
- **Last updated:** 04/19/2016