MEDICARE: HALSTEAD HOME HEALTH CARE

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	A040011	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A040011	OTHER	KS	KDHE

General Provider Information

NPI Number	:	1760671911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALSTEAD HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	328 POPLAR ST
Second Line	:
City	:	HALSTEAD
State	:	KS
Zip	:	67056-2014
Country	:	US
Telephone Number	:	316-835-3100
Fax Number	:

Provider Business Practice Location Address
First Line	:	328 POPLAR ST
Second Line	:
City	:	HALSTEAD
State	:	KS
Zip	:	67056-2014
Country	:	US
Telephone Number	:	316-835-3100
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. ELIZABETH GRABER
Credential	:
Telephone Number	:	316-835-3100

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	10/23/2007

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Directions to “HALSTEAD HOME HEALTH CARE ” Practice Location

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