Provider Demographics
NPI:1295738037
Name:SPECTRUM HOME HEALTH, INC.
Entity type:Organization
Organization Name:SPECTRUM HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:APPL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-831-2979
Mailing Address - Street 1:2915 STRONG AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66106-2144
Mailing Address - Country:US
Mailing Address - Phone:913-831-2979
Mailing Address - Fax:913-831-9566
Practice Address - Street 1:2915 STRONG AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66106-2144
Practice Address - Country:US
Practice Address - Phone:913-831-2979
Practice Address - Fax:913-831-9566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO888-1HH251E00000X
KSA-105-012-2251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO586991101Medicaid
KS201150270AMedicaid
KS201150270AMedicaid