Provider Demographics
NPI:1134426943
Name:PRAIRIE VIEW HEALTHCARE, INC.
Entity type:Organization
Organization Name:PRAIRIE VIEW HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPORITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-515-8203
Mailing Address - Street 1:4811 LAMAR AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-1765
Mailing Address - Country:US
Mailing Address - Phone:913-620-6162
Mailing Address - Fax:913-273-1080
Practice Address - Street 1:4811 LAMAR AVE STE 4
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-1765
Practice Address - Country:US
Practice Address - Phone:913-620-6162
Practice Address - Fax:913-273-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251G00000X251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based