Provider Demographics
NPI:1861823858
Name:HOME OF THE HEART
Entity Type:Organization
Organization Name:HOME OF THE HEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:620-231-0989
Mailing Address - Street 1:516 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762
Mailing Address - Country:US
Mailing Address - Phone:620-231-0989
Mailing Address - Fax:620-231-1208
Practice Address - Street 1:516 OHIO ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6430
Practice Address - Country:US
Practice Address - Phone:620-231-0989
Practice Address - Fax:620-231-1208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS104100000X, 251C00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services