Provider Demographics
NPI:1285984583
Name:BARE ESSENTIALS HOME CARE INC.
Entity type:Organization
Organization Name:BARE ESSENTIALS HOME CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:WASHAM
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:816-333-4500
Mailing Address - Street 1:3200 WAYNE AVE.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109
Mailing Address - Country:US
Mailing Address - Phone:816-333-4500
Mailing Address - Fax:816-333-2453
Practice Address - Street 1:3200 WAYNE AVE.
Practice Address - Street 2:SUITE 103
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109
Practice Address - Country:US
Practice Address - Phone:816-333-4500
Practice Address - Fax:816-333-2453
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARE ESSENTIALS HOME CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0002713253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1063796811Medicaid
MO1285752352Medicaid