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General NPI Number Information
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NPI Number | 1639884182
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Entity Type | Organization
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Legal Business Name | LEGACY HEALTH KANSAS LLC
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 2024 N WOODLAWN ST STE 406
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City | WICHITA
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State | KS
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Zip | 67208-1879
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Country | US
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Telephone | 316-765-4748
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Fax | 316-221-2050
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Provider Business Mailing Address
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Address Line | 2024 N WOODLAWN ST STE 406
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City | WICHITA
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State | KS
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Zip | 67208-1879
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Country | US
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Telephone | 316-755-8785
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Fax | 316-221-2050
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MICHELLE D MORALES
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Credential |
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Telephone | 316-755-8785
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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 |
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