Provider Demographics
NPI:1902557788
Name:FASSNIGHT HOME CARE AND RESPITE LLC
Entity Type:Organization
Organization Name:FASSNIGHT HOME CARE AND RESPITE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO- OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:417-814-5162
Mailing Address - Street 1:1700 S CAMPBELL AVE STE C102
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-2095
Mailing Address - Country:US
Mailing Address - Phone:417-814-5162
Mailing Address - Fax:
Practice Address - Street 1:1700 S CAMPBELL AVE STE C102
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-2095
Practice Address - Country:US
Practice Address - Phone:417-814-5162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care