NPIMap

Organization Active NPI

Four Seasons in Home Services, LLC

  • Home Health Agency
  • Clinton, MO
National Provider Identifier
1477616522
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
FOUR SEASONS IN HOME SERVICES, LLC
Practice address
908 N 2ND St
Clinton, MO 64735-1453
Phone
(660) 826-2600
Fax
(660) 826-0021
NPI assigned
Dec 19, 2006
Last updated
May 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Mr. Richard J Destefane
Title
President
Phone
(660) 826-2600

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary
Personal Care Attendant 3747P1801X NU
Nurse's Aide 376K00000X NU
Licensed Practical Nurse 164W00000X NU

Addresses

Primary practice location

908 N 2ND St
Clinton, MO 64735-1453

Mailing address

908 N 2ND St
Clinton, MO 64735-1453
Phone (660) 826-2600

Other identifiers 2

IdentifierTypeStateIssuer
261481105MedicaidMO
376K0000XMedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Four Seasons in Home Services LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1477616522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351453",
            "telephone_number": "660-826-2600",
            "fax_number": "660-826-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351453",
            "telephone_number": "660-826-2600",
            "fax_number": "660-826-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS IN HOME SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "DESTEFANE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "660-826-2600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261481105",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376K0000X",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.