Healthcare Provider Details

I. General information

NPI: 1174543631
Provider Name (Legal Business Name): PREFERRED CARE HOME REHABILITATION SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E PRAIRIE AVE SUITE B
GIRARD KS
66743-1546
US

IV. Provider business mailing address

125 E PRAIRIE AVE SUITE B
GIRARD KS
66743-1546
US

V. Phone/Fax

Practice location:
  • Phone: 620-724-7220
  • Fax: 620-724-7221
Mailing address:
  • Phone: 620-724-7220
  • Fax: 620-724-7221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA109006
License Number StateKS

VIII. Authorized Official

Name: MR. JASON L. RAWLINGS
Title or Position: ADMINISTRATOR
Credential: P.T.
Phone: 620-724-7220