=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558343145
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTERWELL HEALTH SERVICES USA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2005
-----------------------------------------------------
Last Update Date | 08/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34 W FOREST AVE. SUITE B
-----------------------------------------------------
City | HOMERVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-636-3001
-----------------------------------------------------
Fax | 912-210-5608
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6330 SPRINT PARKWAY SUITE 300
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66211-1157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-814-2206
-----------------------------------------------------
Fax | 913-814-2029
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT, HOME HEALTH
-----------------------------------------------------
Name | LLOYD KIRK ALLEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 502-580-1069
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 092275H
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------