Healthcare Provider Details

I. General information

NPI: 1013801844
Provider Name (Legal Business Name): ICT HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 W CENTRAL AVE STE E
ANDOVER KS
67002-9694
US

IV. Provider business mailing address

324 W CENTRAL AVE STE D
ANDOVER KS
67002-9694
US

V. Phone/Fax

Practice location:
  • Phone: 316-448-1274
  • Fax: 316-733-0995
Mailing address:
  • Phone: 316-448-1274
  • Fax: 316-733-0995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANDREA LAW
Title or Position: DIRECTOR
Credential:
Phone: 316-733-2645