Healthcare Provider Details

I. General information

NPI: 1407852643
Provider Name (Legal Business Name): CASS MEDICAL CENTER HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 E ELM ST
HARRISONVILLE MO
64701-2024
US

IV. Provider business mailing address

1604 E ELM ST
HARRISONVILLE MO
64701-2024
US

V. Phone/Fax

Practice location:
  • Phone: 816-887-0718
  • Fax: 816-380-1896
Mailing address:
  • Phone: 816-887-0718
  • Fax: 816-380-1896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number662-6
License Number StateMO

VIII. Authorized Official

Name: MR. JOHN CHRISTOPHER LANG
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 816-380-5888