Healthcare Provider Details

I. General information

NPI: 1407600729
Provider Name (Legal Business Name): INDEPENDENT HOME SOLUTIONS - KANSAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12725 BRIAR DR
LEAWOOD KS
66209-1889
US

IV. Provider business mailing address

12725 BRIAR DR
LEAWOOD KS
66209-1889
US

V. Phone/Fax

Practice location:
  • Phone: 816-315-4284
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DAVID BANGERT
Title or Position: CEO
Credential:
Phone: 913-228-3039