Provider Demographics
NPI:1013421353
Name:M-CARE HEALTHCARE LLC
Entity type:Organization
Organization Name:M-CARE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:O
Authorized Official - Last Name:MOGOI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:316-519-1543
Mailing Address - Street 1:731 N MCLEAN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4935
Mailing Address - Country:US
Mailing Address - Phone:316-461-0339
Mailing Address - Fax:316-221-1000
Practice Address - Street 1:731 N MCLEAN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4935
Practice Address - Country:US
Practice Address - Phone:316-461-0339
Practice Address - Fax:316-221-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-22
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty