OrganizationActive
Bootheel Area Independent Living Service
NPI 1609907864 · Home Health Agency · Kennett, MO
Provider details
- NPI number
- 1609907864
- Entity type
- Organization
- Primary specialty
- Home Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Tim Shaw, Executive Director(573) 888-0002
- License
- 00 (MO)
Specialties & taxonomies
Agencies
Practice location
719 Teaco Rd
Kennett, MO 63857-3741
Phone: (573) 888-0002
Fax: (573) 888-2513
Approximate (ZIP-level) locationGet directions
Mailing address
719 Teaco Rd
Kennett, MO 63857-3741
Other names (DBA / former)
- Other name
- Bails
Registry dates
- Enumerated
- 2007-03-08
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.