Healthcare Provider Details

I. General information

NPI: 1740035906
Provider Name (Legal Business Name): MR. THATCHER HORAK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 SW 29TH ST
TOPEKA KS
66611-1909
US

IV. Provider business mailing address

2222 SW 29TH ST
TOPEKA KS
66611-1909
US

V. Phone/Fax

Practice location:
  • Phone: 785-380-5400
  • Fax:
Mailing address:
  • Phone: 785-380-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA089064
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: