Provider Demographics
NPI:1245576024
Name:1ST CARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:1ST CARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:MEKONEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:913-526-5980
Mailing Address - Street 1:6301 ROCKHILL RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1124
Mailing Address - Country:US
Mailing Address - Phone:816-581-6864
Mailing Address - Fax:816-581-6867
Practice Address - Street 1:6301 ROCKHILL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1124
Practice Address - Country:US
Practice Address - Phone:816-581-6864
Practice Address - Fax:816-581-6867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-23
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health