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General NPI Number Information
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NPI Number | 1700389855
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Entity Type | Organization
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Legal Business Name | LIFE CARE HOME HEALTH SERVICES LLC
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Dates
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Enumeration Date | 03/15/2018
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Last Update Date | 03/15/2018
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Provider Practice Location Address
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Address Line | 8101 MISSION RD
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-5245
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Country | US
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Telephone | 913-385-4110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 200
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City | AUGUSTA
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State | GA
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Zip | 30903-0200
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Country | US
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Telephone | 706-854-7428
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | JEREMY COHEN
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Credential |
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Telephone | 706-854-7428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | A046244
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License Number State | KS
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