Provider Demographics
NPI:1013461045
Name:HOME HEALTH LIFE LLC
Entity Type:Organization
Organization Name:HOME HEALTH LIFE LLC
Other - Org Name:DONOVAN'S HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-492-2992
Mailing Address - Street 1:PO BOX 1803
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66505-1803
Mailing Address - Country:US
Mailing Address - Phone:785-492-2992
Mailing Address - Fax:785-370-8000
Practice Address - Street 1:617 HIGHLAND RIDGE DR APT 6301
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-5004
Practice Address - Country:US
Practice Address - Phone:785-492-2992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-081-011251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health