Provider Demographics
NPI:1275836678
Name:SACRED HEART HOME CARE
Entity Type:Organization
Organization Name:SACRED HEART HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-334-1058
Mailing Address - Street 1:7735 WASHINGTON AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-2444
Mailing Address - Country:US
Mailing Address - Phone:913-334-1058
Mailing Address - Fax:913-334-1196
Practice Address - Street 1:7735 WASHINGTON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2444
Practice Address - Country:US
Practice Address - Phone:913-334-1058
Practice Address - Fax:913-334-1196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA105169251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health