Provider Demographics
NPI:1093742512
Name:COMPLETE HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:COMPLETE HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:FAE
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:316-260-5000
Mailing Address - Street 1:400 N WOODLAWN ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-4338
Mailing Address - Country:US
Mailing Address - Phone:316-260-5000
Mailing Address - Fax:316-260-5014
Practice Address - Street 1:400 N WOODLAWN ST
Practice Address - Street 2:SUITE 15
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4338
Practice Address - Country:US
Practice Address - Phone:316-260-5000
Practice Address - Fax:316-260-5014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA087097251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200250230AMedicaid