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Organization
FOUR SEASONS IN HOME SERVICES, LLC
Active
Organization
FOUR SEASONS IN HOME SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD JOSEPH DESTEPHANE (PRESIDENT)
(660) 826-2600
Entity
Organization
Contact information
Practice address
908 N 2ND ST, CLINTON, MO 64735-1453
(660) 826-2600
(660) 826-0021
Mailing address
908 N 2ND ST, CLINTON, MO 64735-1453
(660) 826-2600
(660) 826-0021
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
373H00000X
Day Training/Habilitation Specialist
—
NULL
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
—
NULL
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
03/01/2007
Last updated
05/20/2024
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