Provider Demographics
NPI:1780209882
Name:MY HOME CARE LLC
Entity Type:Organization
Organization Name:MY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOMPHIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMPHONE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:316-358-9423
Mailing Address - Street 1:1037 S BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-2232
Mailing Address - Country:US
Mailing Address - Phone:316-358-9423
Mailing Address - Fax:316-358-9975
Practice Address - Street 1:1037 S BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-2232
Practice Address - Country:US
Practice Address - Phone:316-358-9423
Practice Address - Fax:316-358-9975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health