Provider Demographics
NPI:1063051688
Name:DIFFERENCE MAKERS IN-HOME CARE, LLC
Entity type:Organization
Organization Name:DIFFERENCE MAKERS IN-HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DESIGNATED MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-521-8173
Mailing Address - Street 1:1237 YELLOWSTONE
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5752
Mailing Address - Country:US
Mailing Address - Phone:573-521-8173
Mailing Address - Fax:
Practice Address - Street 1:1237 YELLOWSTONE
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5752
Practice Address - Country:US
Practice Address - Phone:573-521-8173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care