Provider Demographics
NPI:1518251156
Name:GREAT PLAINS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:GREAT PLAINS HEALTHCARE, INC.
Other - Org Name:GATEWAY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:210 1ST ST SW STE A
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-1407
Mailing Address - Country:US
Mailing Address - Phone:515-532-5121
Mailing Address - Fax:
Practice Address - Street 1:210 1ST ST SW STE A
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:IA
Practice Address - Zip Code:50525-1407
Practice Address - Country:US
Practice Address - Phone:515-532-5121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA167405Medicare Oscar/Certification