Provider Demographics
NPI:1083777189
Name:HOME HEALTHCARE CONNECTION, INC.
Entity Type:Organization
Organization Name:HOME HEALTHCARE CONNECTION, INC.
Other - Org Name:HOME HEALTHCARE CONNECTION SOUTHEAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CLARICE
Authorized Official - Middle Name:J
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHD
Authorized Official - Phone:316-267-4663
Mailing Address - Street 1:8415 E 32ND ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2607
Mailing Address - Country:US
Mailing Address - Phone:316-267-4663
Mailing Address - Fax:316-522-2551
Practice Address - Street 1:115 S 18TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-3365
Practice Address - Country:US
Practice Address - Phone:620-421-1073
Practice Address - Fax:620-421-2824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA050008251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100017330CMedicaid
KS100017330CMedicaid