Provider Demographics
NPI:1497968127
Name:HOME HEALTH OF KANSAS, LLC
Entity Type:Organization
Organization Name:HOME HEALTH OF KANSAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:NDUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-869-0015
Mailing Address - Street 1:7607 E HARRY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-3111
Mailing Address - Country:US
Mailing Address - Phone:316-684-5122
Mailing Address - Fax:316-684-5122
Practice Address - Street 1:7607 E HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-3111
Practice Address - Country:US
Practice Address - Phone:316-684-5122
Practice Address - Fax:316-684-5122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSZ087013251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS171568Medicaid
KS171568Medicare ID - Type UnspecifiedHOSPICE