Healthcare Provider Details

I. General information

NPI: 1043123821
Provider Name (Legal Business Name): SUITE CARE HOME PLUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2272 N FOUNTAIN ST
WICHITA KS
67220-2840
US

IV. Provider business mailing address

7708 E GILBERT ST
WICHITA KS
67207-2308
US

V. Phone/Fax

Practice location:
  • Phone: 316-301-2907
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TIARA BURNS
Title or Position: OPERATOR
Credential:
Phone: 316-990-0036