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General NPI Number Information
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NPI Number | 1356465215
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Entity Type | Organization
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Legal Business Name | TARA GARDENS, INC.
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Dates
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Enumeration Date | 03/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1110 E CARPENTER ST
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City | IOLA
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State | KS
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Zip | 66749-2143
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Country | US
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Telephone | 620-365-3107
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Fax | 620-365-8652
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Provider Business Mailing Address
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Address Line | 1110 E CARPENTER ST
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City | IOLA
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State | KS
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Zip | 66749-2143
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Country | US
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Telephone | 620-365-3107
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Fax | 620-365-8652
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Authorized Official
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Title or Position | MANAGEMENT COMPANY REPRESENTATIVE
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Name | JEAN L WILCOX
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Credential |
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Telephone | 402-898-1079
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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 |
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License Number State | KS
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