Healthcare Provider Details

I. General information

NPI: 1689985731
Provider Name (Legal Business Name): KANSAS HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

962 S. CLEARWATER CREEK DR
OLATHE KS
66061-5260
US

IV. Provider business mailing address

962 S. CLEARWATER CREEK DR
OLATHE KS
66061-5260
US

V. Phone/Fax

Practice location:
  • Phone: 913-944-3889
  • Fax: 913-839-2010
Mailing address:
  • Phone: 913-944-3889
  • Fax: 913-839-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA046167
License Number StateKS

VIII. Authorized Official

Name: MICHAEL MATHEW KATUNZI
Title or Position: PARTNER/RN
Credential: RN, BSN
Phone: 19139443889