House of Mariam Holistic Home Health Care LLC

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Legal business name

HOUSE OF MARIAM HOLISTIC HOME HEALTH CARE LLC

Practice address

1543 S Sonora Dr
Columbia, MO 65201-9471

Phone

(708) 314-8159

NPI assigned

Aug 10, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vida H Amegashie

Title

Ceo

Phone

(708) 314-8159

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723248000000",
    "number": "1295566321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 S SONORA DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652019471",
            "telephone_number": "708-314-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 S SONORA DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652019471",
            "telephone_number": "708-314-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF MARIAM HOLISTIC HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A",
        "authorized_official_last_name": "AMEGASHIE",
        "authorized_official_first_name": "VIDA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-314-8159"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prevention Professional in Columbia, MO
• Providers in Columbia, MO by specialty
• Prevention Professional in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.