Bootheel Area Independent Living Service

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

00 Issued in MO

Legal business name

BOOTHEEL AREA INDEPENDENT LIVING SERVICE

Practice address

719 Teaco Rd
Kennett, MO 63857-3741

Phone

(573) 888-0002

Fax

(573) 888-2513

NPI assigned

Mar 8, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tim B Shaw

Title

Executive Director

Phone

(573) 888-0002

Specialties & licenses 1

Addresses

Other names 1

• BAILS Other name

Tax ID family

Bails2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Bootheel Area Independent Living Services, Inc.

  • Home Health Agency
  • Kennett, MO
  • NPI 1861557183
  NPD tax ID

Locations

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609907864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 TEACO RD",
            "address_2": "PO BOX 326",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573741",
            "telephone_number": "573-888-0002",
            "fax_number": "573-888-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573741",
            "telephone_number": "573-888-0002",
            "fax_number": "573-888-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTHEEL AREA INDEPENDENT LIVING SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "573-888-0002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAILS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shawny Jerretta Blake, BCHIS
• Jeffrey Marcellius Bogan
• Bobby D. Boland, AFNP
• Kyaughja Shamamundre Bondzie
• Rachel Leigh Book
• Bootheel Area Independent Living Services, Inc.
• Mia Boren
• Jennifer A Bost, B.S.
• Sharon Ann Bostic
• Christopher Michael Bowen

• Home Health Agency in Kennett, MO
• Providers in Kennett, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.