NPI 1548776131

Mba In-Home Service LLC

Organisation Exclusive Provider Organization Sikeston, MO

Practice location

Address: 1217 W Malone Ave, Sikeston, MO 63801
Phone: (573) 481-1088
Fax: (573) 475-8774
Mailing address: PO Box 1386, Sikeston, MO 63801-1386

Authorised official

Name: Rhonda L Williams
Title: Director/Owner
Phone: (573) 481-1088

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 6448 (MO)

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Registry record

NPI: 1548776131
Entity type: Organization
NPI issued: 19 Dec 2017
Record last updated: 19 Dec 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.