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General NPI Number Information
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NPI Number | 1326396292
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Entity Type | Organization
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Legal Business Name | J & D HEALTHCARE SERVICES
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Dates
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Enumeration Date | 08/26/2012
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Last Update Date | 08/26/2012
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Provider Practice Location Address
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Address Line | 1927 S LEEANNE LN
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City | WICHITA
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State | KS
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Zip | 67207-7709
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Country | US
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Telephone | 316-393-1905
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Fax | 316-686-3429
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Provider Business Mailing Address
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Address Line | 1927 S LEEANNE LN
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City | WICHITA
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State | KS
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Zip | 67207-7709
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Country | US
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Telephone | 316-393-1905
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Fax | 316-686-3429
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AMUNEKE RAYMOND
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Credential | RN
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Telephone | 316-393-1905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | A-087-156
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License Number State | KS
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