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Organization
MAGNIFICENT CARING HOME HEALTH
Active
Organization
MAGNIFICENT CARING HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMICKA NELSON-BOBO (OWNER/ DIRECTOR)
(314) 629-7281
Entity
Organization
Contact information
Practice address
12215 WINTERSET DR, BLACK JACK, MO 63033-7333
(314) 629-7281
(314) 699-4648
Mailing address
12215 WINTERSET DR, BLACK JACK, MO 63033-7333
(314) 629-7281
(314) 699-4648
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
132700000X
Dietary Manager
—
NULL
132700000X
Dietary Manager
—
—
174200000X
Meals Provider
—
NULL
251B00000X
Case Management Agency
—
NULL
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251E00000X
Home Health Agency
Primary
—
NULL
251J00000X
Nursing Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
09/03/2020
Last updated
09/02/2022
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