Provider Demographics
NPI:1982429858
Name:PUZZLE PIECES OF HOPE HOME HEALTHCARE, LLC
Entity type:Organization
Organization Name:PUZZLE PIECES OF HOPE HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REVENDA
Authorized Official - Middle Name:SHERA
Authorized Official - Last Name:BECKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-477-7480
Mailing Address - Street 1:8670 N WYANDOTTE ST APT 417
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2767
Mailing Address - Country:US
Mailing Address - Phone:314-477-7480
Mailing Address - Fax:
Practice Address - Street 1:8670 N WYANDOTTE ST APT 417
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2767
Practice Address - Country:US
Practice Address - Phone:314-477-7480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health