Healthcare Provider Details

I. General information

NPI: 1457262321
Provider Name (Legal Business Name): HIGHLAND HOME CARE KS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10131 W 84TH ST
OVERLAND PARK KS
66212-4412
US

IV. Provider business mailing address

10131 W 84TH ST
OVERLAND PARK KS
66212-4412
US

V. Phone/Fax

Practice location:
  • Phone: 913-287-0333
  • Fax:
Mailing address:
  • Phone: 913-287-0333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: LISTONE MWAMBURI
Title or Position: OWNER/MANAGER
Credential:
Phone: 816-352-4674