Organization
SOUTHERN ROOTS IN-HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA LYNN SQUIRES (OWNER)
(573) 703-2229
Entity
Organization
Contact information
Practice address
301 S BENTON ST MH, MOREHOUSE, MO 63868-0301
(573) 667-0028
(573) 667-0028
Mailing address
301 S BENTON ST MH, SIKESTON, MO 63801-0301
(573) 667-0028
(573) 667-0028
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
985864
MO
Other
Enumeration date
04/06/2017
Last updated
04/06/2017
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