Provider Demographics
NPI:1851332639
Name:SAINT LUKES HOSPICE OF LEAVENWORTH LLC
Entity Type:Organization
Organization Name:SAINT LUKES HOSPICE OF LEAVENWORTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-360-8010
Mailing Address - Street 1:3100 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2658
Mailing Address - Country:US
Mailing Address - Phone:816-360-8010
Mailing Address - Fax:
Practice Address - Street 1:920 6TH AVE
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-3225
Practice Address - Country:US
Practice Address - Phone:913-758-9034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT LUKES HEALTH SYSTEM HOME CARE AND HOSPICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-10
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100088000DMedicaid
KS100088000DMedicaid