Provider Demographics
NPI:1376555151
Name:PREFERRED HEALTH AT HOME, LLC
Entity Type:Organization
Organization Name:PREFERRED HEALTH AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:913-284-6442
Mailing Address - Street 1:1734 E 63RD ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-3543
Mailing Address - Country:US
Mailing Address - Phone:816-361-2700
Mailing Address - Fax:816-361-2703
Practice Address - Street 1:1734 E 63RD ST
Practice Address - Street 2:STE. 506
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3543
Practice Address - Country:US
Practice Address - Phone:816-361-2700
Practice Address - Fax:816-361-2703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
39445019OtherBLUE CROSS BLUE SHIELD
=========OtherHUMANA
=========OtherCARE IMPROVEMENT PLUS
39445019OtherBLUE CROSS BLUE SHIELD