Healthcare Provider Details

I. General information

NPI: 1407188865
Provider Name (Legal Business Name): DAYDREAM SENIOR CARE- KANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9331 W 87TH ST
OVERLAND PARK KS
66212-3753
US

IV. Provider business mailing address

9331 W 87TH ST
OVERLAND PARK KS
66212-3753
US

V. Phone/Fax

Practice location:
  • Phone: 913-962-6500
  • Fax: 913-631-5370
Mailing address:
  • Phone: 913-962-6500
  • Fax: 913-631-5370

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DOUGLAS J KISGEN
Title or Position: FRANCHISE OWNER
Credential:
Phone: 913-962-6500