Provider Demographics
NPI:1154510121
Name:HYATT HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:HYATT HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARDOSO
Authorized Official - Middle Name:MOHAMUD
Authorized Official - Last Name:JAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-283-3200
Mailing Address - Street 1:2122 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64127-1218
Mailing Address - Country:US
Mailing Address - Phone:816-283-3200
Mailing Address - Fax:816-283-3202
Practice Address - Street 1:2122 E 12TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64127-1218
Practice Address - Country:US
Practice Address - Phone:816-283-3200
Practice Address - Fax:816-283-3202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251S00000X
MO00846227251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health