Provider Demographics
NPI:1083159974
Name:UNITED HOME CARE LLC.
Entity Type:Organization
Organization Name:UNITED HOME CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-749-7103
Mailing Address - Street 1:6810 ANTIOCH RD
Mailing Address - Street 2:APT 257
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1202
Mailing Address - Country:US
Mailing Address - Phone:913-749-7103
Mailing Address - Fax:
Practice Address - Street 1:6810 ANTIOCH RD
Practice Address - Street 2:APT 257
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-1202
Practice Address - Country:US
Practice Address - Phone:913-749-7103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8519324253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS8518324Medicaid