Healthcare Provider Details

I. General information

NPI: 1306680343
Provider Name (Legal Business Name): NEXGEN HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 OREAD WEST ST STE 103
LAWRENCE KS
66049-3969
US

IV. Provider business mailing address

1425 OREAD WEST ST STE 103
LAWRENCE KS
66049-3969
US

V. Phone/Fax

Practice location:
  • Phone: 785-856-0192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS YOCUM
Title or Position: OWNER / ALT. ADMINISTRATOR
Credential:
Phone: 785-856-0192