NPI Registry
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Organization

PHOENIX HOME CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GEORGE SCOTT HERMAN (PRESIDENT AND SECRETARY)
(903) 390-4040
Entity
Organization

Contact information

Practice address
1839 E INDEPENDENCE ST STE K, SPRINGFIELD, MO 65804-3753
(417) 818-3565
Mailing address
3450 N. ROCK RD., #213 ATTN: DEBRA MULLEN, WITCHITA, KS 67226-1352
(316) 688-5511

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
372500000X
Chore Provider
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
3747P1801X
Personal Care Attendant
376J00000X
Homemaker
376K00000X
Nurse's Aide

Other

Enumeration date
04/29/2011
Last updated
12/10/2021
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