Basic Information
Provider Information
NPI: 1750016069
EntityType: 2
ReplacementNPI:  
OrganizationName: HARBOR HOSPICE OF NORTH MISSOURI LP
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Mailing Information
Address1: 3406 COLLEGE ST STE 200
Address2:  
City: BEAUMONT
State: TX
PostalCode: 777014612
CountryCode: US
TelephoneNumber: 4097302046
FaxNumber:  
Practice Location
Address1: 114 N MAIN ST
Address2:  
City: PLATTSBURG
State: MO
PostalCode: 644771236
CountryCode: US
TelephoneNumber: 8166011512
FaxNumber: 8164665321
Other Information
ProviderEnumerationDate: 07/20/2022
LastUpdateDate: 07/20/2022
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AuthorizedOfficialLastName: CARTER
AuthorizedOfficialFirstName: KAREN
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AuthorizedOfficialTitleorPosition: EXEC ADIN ASST
AuthorizedOfficialTelephone: 4097302046
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 07/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251G00000X  Y AgenciesHospice Care, Community Based 

No ID Information.


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