Organization
BOULDERWOOD ESTATES LLC
Active
Other names
boulderwood estates
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN EDMONDS (MEMBER)
(417) 860-1300
Entity
Organization
Contact information
Practice address
1111 CARE AVE, NIXA, MO 65714-9679
(417) 374-7755
Mailing address
PO BOX 870, NIXA, MO 65714-0870
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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