Provider Demographics
NPI:1568764520
Name:INNOVATIVE SENIOR CARE HOME HEALTH OF KANSAS LLC
Entity Type:Organization
Organization Name:INNOVATIVE SENIOR CARE HOME HEALTH OF KANSAS LLC
Other - Org Name:WESLEY HEALTHCARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, HOME HEALTH & HOSPICE
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-565-8439
Mailing Address - Street 1:1 PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6527
Mailing Address - Country:US
Mailing Address - Phone:615-344-9551
Mailing Address - Fax:
Practice Address - Street 1:1638 S OHIO ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-6360
Practice Address - Country:US
Practice Address - Phone:785-825-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH AT HOME-BHS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-24
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
177187Medicare Oscar/Certification