Healthcare Provider Details

I. General information

NPI: 1205978244
Provider Name (Legal Business Name): MT. HOPE HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 E MAIN ST
MOUNT HOPE KS
67108-9408
US

IV. Provider business mailing address

704 E MAIN ST
MOUNT HOPE KS
67108-9408
US

V. Phone/Fax

Practice location:
  • Phone: 316-667-2431
  • Fax: 316-661-2352
Mailing address:
  • Phone: 316-667-2431
  • Fax: 316-661-2352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA-087-048
License Number StateKS

VIII. Authorized Official

Name: PATRICIA J KISSICK
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 316-667-2431