Organization
LIFE CARE HOME HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK W GRIFFIN (PRESIDENT)
(706) 303-5500
Entity
Organization
Contact information
Practice address
8101 MISSION RD, PRAIRIE VILLAGE, KS 66208-5238
(913) 385-4110
(913) 385-4138
Mailing address
PO BOX 200, AUGUSTA, GA 30903-0200
(706) 303-5500
(706) 854-7382
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
A-046-088
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17D0895806
CLIA WAIVER NUMBER
KS
01
—
A-046-088
HHA LICENSE
KS
Enumeration date
05/15/2007
Last updated
02/12/2016
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