Healthcare Provider Details

I. General information

NPI: 1205832987
Provider Name (Legal Business Name): SPECTRUM PRIVATE CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7734 HEDGE LANE TER
SHAWNEE KS
66227-3017
US

IV. Provider business mailing address

7734 HEDGE LANE TER
SHAWNEE KS
66227-3017
US

V. Phone/Fax

Practice location:
  • Phone: 913-299-7100
  • Fax: 913-299-7102
Mailing address:
  • Phone: 913-299-7100
  • Fax: 913-299-7102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA105020
License Number StateKS

VIII. Authorized Official

Name: MS. EILEEN OREL
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 913-299-7100