Healthcare Provider Details

I. General information

NPI: 1063769743
Provider Name (Legal Business Name): SPRINGVIEW HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10644 W 87TH ST
OVERLAND PARK KS
66214-1651
US

IV. Provider business mailing address

10644 W 87TH ST
OVERLAND PARK KS
66214-1651
US

V. Phone/Fax

Practice location:
  • Phone: 913-310-0166
  • Fax:
Mailing address:
  • Phone: 913-310-0166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberB046048
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberB046048
License Number StateKS

VIII. Authorized Official

Name: MR. DAVID NDUNGU
Title or Position: OWNER-OPERATOR
Credential:
Phone: 913-244-4492