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General NPI Number Information
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NPI Number | 1568686053
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Entity Type | Organization
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Legal Business Name | AT-HOME SUPPORT CARE, INC
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1420 C OF E DR SUITE 300
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City | EMPORIA
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State | KS
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Zip | 66801-2599
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Country | US
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Telephone | 620-341-9350
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Fax | 620-341-9375
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Provider Business Mailing Address
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Address Line | 1420 C OF E DR SUITE 300
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City | EMPORIA
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State | KS
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Zip | 66801-2599
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Country | US
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Telephone | 620-341-9350
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Fax | 620-341-9375
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. TERESA JEAN HURLOCKER
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Credential | RN
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Telephone | 620-341-9350
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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 | A056013
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License Number State | KS
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