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General NPI Number Information
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NPI Number | 1033554530
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Entity Type | Organization
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Legal Business Name | THE MAMIE B TAYLOR IN HOME CARE HEALTH AGENCY LLC
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Dates
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Enumeration Date | 05/09/2013
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Last Update Date | 05/09/2013
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Provider Practice Location Address
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Address Line | 1909 COYOTE CT
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City | JUNCTION CITY
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State | KS
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Zip | 66441-2665
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Country | US
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Telephone | 785-410-4124
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Fax | 785-238-8312
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Provider Business Mailing Address
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Address Line | 1909 COYOTE CT
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City | JUNCTION CITY
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State | KS
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Zip | 66441-2665
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Country | US
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Telephone | 785-410-4124
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Fax | 785-238-8312
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Authorized Official
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Title or Position | CEO
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Name | SALLIE L BROWN
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Credential |
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Telephone | 785-410-4124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 98575
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License Number State | KS
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