Organization
BOOTHEEL AREA INDEPENDENT LIVING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM B SHAW (EXECUTIVE DIRECTOR)
(573) 888-0002
Entity
Organization
Contact information
Practice address
719 TEACO RD, KENNETT, MO 63857-3741
(573) 888-0002
(573) 888-0708
Mailing address
PO BOX 326, 719 TEACO ROAD, KENNETT, MO 63857-0326
(573) 888-0002
(573) 888-0708
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
01
MO
Other
Enumeration date
12/27/2006
Last updated
07/21/2022
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