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NPI Code Detail

MEDICARE: CENTERWELL HEALTH SERVICES (CERTIFIED), INC.

MEDICARE: CENTERWELL HEALTH SERVICES (CERTIFIED), INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1107234OTHERG2
22117427OTHERG2
3113414024OTHERG2
4113414024GOTHERG2
5107937319OTHERG2
6235397OTHERG2
7115712OTHERG2
8249710OTHERG2
9080053OTHERG2
10112645333OTHERG2
11146544OTHERG2
12013100POTHERG2
131016457OTHERG2
142196640OTHERG2

General Provider Information

NPI Number : 1023045390
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTERWELL HEALTH SERVICES (CERTIFIED), INC.
Provider Business Mailing Address
First Line : 6330 SPRINT PKWY STE 300
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66211-1157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4776 NEW BROAD ST
Second Line : SUITE 110
City : ORLANDO
State : FL
Zip : 32814-6423
Country : US
Telephone Number : 407-894-5703
Fax Number :
Authorized Official
Title or Position : SIGNATORY AUTHORITY
Name : JOHN NICHOLS
Credential :
Telephone Number : 407-894-5703
Provider Enumeration Date : 06/26/2006
Last Update Date : 12/20/2023

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Directions to “CENTERWELL HEALTH SERVICES (CERTIFIED), INC. ” Practice Location

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