BOULDERWOOD ESTATES
NPI 1669928834
In Home Supportive Care in Nixa, MO

Q: What is Boulderwood Estates LLC's NPI number?

The NPI number for Boulderwood Estates LLC is 1669928834. It was assigned to this organization in the NPPES registry on August 28, 2016. The provider is doing business as Boulderwood Estates.

Q: What is Boulderwood Estates LLC's specialty?

The primary specialty registered for this NPI is In Home Supportive Care with taxonomy code 253Z00000X.

Active since August 28, 2016

1111 CARE AVE, NIXA, MO 65714(417) 374-7755 Get Directions Write a Review

NPPES record last updated: August 28, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Boulderwood Estates NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOULDERWOOD ESTATES (NPI 1669928834) is a healthcare organization registered as an in home supportive care in Nixa, Missouri and active in the NPI registry since August 2016. The organization lists Kevin Edmonds, Member, as its authorized official.

NPPES Registry Identity

NPI1669928834

Entity TypeOrganization

Primary Taxonomy253Z00000X

Legal Business NameBOULDERWOOD ESTATES LLC

Location Address1111 CARE AVENixa, MO 65714-9679

Mailing AddressPo Box 870Nixa, MO 65714-0870

Phone(417) 374-7755

Organization SubpartNo

Authorized OfficialKevin EdmondsMember · (417) 860-1300

Enumeration DateAugust 28, 2016

✔ NPI 1669928834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIn Home Supportive CareAgencies

Taxonomy Code253Z00000X

Definition

An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.

1111 CARE AVE, Nixa, MO 65714

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Other Names 1

Doing Business AsBoulderwood Estates

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PROMISE CARE CENTER, LLC

In Home Supportive Care

1111 CARE AVE
NIXA, MO 65714

Christian County (417) 494-5037

PROMISE CARE CENTER, LLC

Assisted Living Facility

1111 CARE AVE
NIXA, MO 65714

Christian County (417) 494-5037

LIFE ENHANCEMENT VILLAGE OF THE OZARKS, INC.

Assisted Living Facility (Assisted Living, Mental Illness)

1111 CARE AVE
NIXA, MO 65714

Christian County (417) 725-6680

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boulderwood Estates LLC's NPI number?

The NPI number for Boulderwood Estates LLC is 1669928834. It was assigned to this organization in the NPPES registry on August 28, 2016. The provider is doing business as Boulderwood Estates.

Where is Boulderwood Estates LLC located?

Boulderwood Estates LLC is located at 1111 Care Ave, Nixa, MO 65714. The listed phone number is (417) 374-7755.

What is Boulderwood Estates LLC's specialty?

The primary specialty registered for this NPI is In Home Supportive Care with taxonomy code 253Z00000X.

When was this NPI record last updated?

The NPPES record for Boulderwood Estates LLC was last updated on August 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.