Provider Demographics
NPI:1083948103
Name:MARY HEALTH OF THE SICK INC.
Entity Type:Organization
Organization Name:MARY HEALTH OF THE SICK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JAWORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:785-408-0605
Mailing Address - Street 1:28175 PLEASANT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HAVENSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66432-9607
Mailing Address - Country:US
Mailing Address - Phone:785-408-0605
Mailing Address - Fax:
Practice Address - Street 1:28175 PLEASANT RIDGE RD
Practice Address - Street 2:
Practice Address - City:HAVENSVILLE
Practice Address - State:KS
Practice Address - Zip Code:66432-9607
Practice Address - Country:US
Practice Address - Phone:785-408-0605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-100833-022251B00000X, 251E00000X, 251F00000X, 251G00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care