Organization Name: | MULBERRY STREET TBI, LLC |
NPI Number: | 1851639645 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSHUA AARON MACK (CO-DIRECTOR) |
Mailing Address: | 1517 Sw State Route 7 Blue Springs |
State: | MO US |
Postal Code: | 640143944 |
Phone Number: | 8162242000 |
Fax Number: | 8162242006 |
NPI Enumeration Date: | 01/29/2013 |
NPI Last Update Date: | 01/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |