Provider Demographics
NPI:1053706390
Name:AMAZING IN HOME SERVICES, LLC
Entity type:Organization
Organization Name:AMAZING IN HOME SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:MITCHUM
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-351-1148
Mailing Address - Street 1:106 LAFAYETTE STREET
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:MO
Mailing Address - Zip Code:63935
Mailing Address - Country:US
Mailing Address - Phone:573-351-1148
Mailing Address - Fax:573-758-9697
Practice Address - Street 1:106 LAFAYETTE STREET
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:MO
Practice Address - Zip Code:63935
Practice Address - Country:US
Practice Address - Phone:573-351-1148
Practice Address - Fax:573-758-9697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care