# FOUR SEASONS IN HOME SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851429807
- **Authorized official:** RICHARD JOSEPH DESTEPHANE (PRESIDENT)
- **Authorized official phone:** (660) 826-2600

## Contact information

- **Practice address:** 908 N 2ND ST, CLINTON, MO 64735-1453
- **Practice address phone:** (660) 826-2600
- **Practice address fax:** (660) 826-0021
- **Mailing address:** 908 N 2ND ST, CLINTON, MO 64735-1453
- **Mailing address phone:** (660) 826-2600
- **Mailing address fax:** (660) 826-0021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 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