Provider Demographics
NPI:1407852643
Name:CASS MEDICAL CENTER HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:CASS MEDICAL CENTER HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-380-5888
Mailing Address - Street 1:1604 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-2024
Mailing Address - Country:US
Mailing Address - Phone:816-887-0718
Mailing Address - Fax:816-380-1896
Practice Address - Street 1:1604 E ELM ST
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-2024
Practice Address - Country:US
Practice Address - Phone:816-887-0718
Practice Address - Fax:816-380-1896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO662-6251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO267558Medicare ID - Type Unspecified