Healthcare Provider Details

I. General information

NPI: 1548264229
Provider Name (Legal Business Name): INTERIM HEALTH CARE OF WICHITA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9920 E HARRY ST
WICHITA KS
67207-5008
US

IV. Provider business mailing address

9920 E HARRY ST
WICHITA KS
67207-5008
US

V. Phone/Fax

Practice location:
  • Phone: 316-265-4295
  • Fax: 316-265-4399
Mailing address:
  • Phone: 316-265-4295
  • Fax: 316-265-4399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberA-087-003
License Number StateKS

VIII. Authorized Official

Name: JAY MORROW STEHLEY
Title or Position: PRESIDENT
Credential:
Phone: 316-265-4295