Provider Demographics
NPI:1629061577
Name:AVALON HOME HEALTH, INC.
Entity Type:Organization
Organization Name:AVALON HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-780-9944
Mailing Address - Street 1:1155 W DENNIS AVE
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5229
Mailing Address - Country:US
Mailing Address - Phone:913-780-9944
Mailing Address - Fax:913-780-9979
Practice Address - Street 1:1155 W DENNIS AVE
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5229
Practice Address - Country:US
Practice Address - Phone:913-780-9944
Practice Address - Fax:913-780-9979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKSA-046-128251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS178047Medicare ID - Type Unspecified