Provider Demographics
NPI:1427184431
Name:CHAUTAUQUA COUNTY HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:CHAUTAUQUA COUNTY HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCNOWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-725-5850
Mailing Address - Street 1:215 N CHAUTAUQUA ST
Mailing Address - Street 2:
Mailing Address - City:SEDAN
Mailing Address - State:KS
Mailing Address - Zip Code:67361-1326
Mailing Address - Country:US
Mailing Address - Phone:620-725-5850
Mailing Address - Fax:620-725-5856
Practice Address - Street 1:215 N CHAUTAUQUA ST
Practice Address - Street 2:
Practice Address - City:SEDAN
Practice Address - State:KS
Practice Address - Zip Code:67361-1326
Practice Address - Country:US
Practice Address - Phone:620-725-5850
Practice Address - Fax:620-725-5856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-010-001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS177067Medicare ID - Type Unspecified