MEDICARE: CARING HEARTS PERSONAL HOME SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	A105-038	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124001672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARING HEARTS PERSONAL HOME SERVICES, INC

Provider Business Mailing Address
First Line	:	1234 STATE AVE.
Second Line	:	STE 375
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-4413
Country	:	US
Telephone Number	:	913-621-3108
Fax Number	:	913-321-7387

Provider Business Practice Location Address
First Line	:	1234 STATE AVE.
Second Line	:	STE 375
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-4413
Country	:	US
Telephone Number	:	913-621-3108
Fax Number	:	913-321-7387

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	DR. LAWRENCE DAVID CRAIG
Credential	:	DVM
Telephone Number	:	913-621-3108

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	06/28/2011

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