Provider Demographics
NPI:1326131574
Name:FAITH HOME HEALTH & HOSPICE, LLC
Entity Type:Organization
Organization Name:FAITH HOME HEALTH & HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOWLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-618-6800
Mailing Address - Street 1:7804 E FUNSTON ST STE 203
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-3107
Mailing Address - Country:US
Mailing Address - Phone:316-618-6800
Mailing Address - Fax:316-618-6800
Practice Address - Street 1:7804 E FUNSTON ST
Practice Address - Street 2:STE 203
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-3107
Practice Address - Country:US
Practice Address - Phone:316-618-6800
Practice Address - Fax:316-618-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA087089251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS171550Medicare ID - Type UnspecifiedHOSPICE