Provider Demographics
NPI:1790390532
Name:WALK IN THE PARK HOME CARE LLC
Entity Type:Organization
Organization Name:WALK IN THE PARK HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-621-4490
Mailing Address - Street 1:409 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2812
Mailing Address - Country:US
Mailing Address - Phone:785-656-4196
Mailing Address - Fax:785-621-4492
Practice Address - Street 1:409 E 22ND ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2812
Practice Address - Country:US
Practice Address - Phone:785-656-4196
Practice Address - Fax:785-621-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1023630746Medicaid