Provider Demographics
NPI:1265620108
Name:AUTUMN HOME PLUS
Entity type:Organization
Organization Name:AUTUMN HOME PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LP,N
Authorized Official - Phone:785-232-0730
Mailing Address - Street 1:747 NW WALNUT LN
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66617-1256
Mailing Address - Country:US
Mailing Address - Phone:785-232-0730
Mailing Address - Fax:785-286-0447
Practice Address - Street 1:747 NW WALNUT LN
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66617-1256
Practice Address - Country:US
Practice Address - Phone:785-232-0730
Practice Address - Fax:785-286-0447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSB089068251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health