Organization
THERAPEUTIC TIME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRECA MARIE KELLEY (ADMINISTRATOR/OWNER)
(316) 347-6633
Entity
Organization
Contact information
Practice address
4438 E FALCON ST, WICHITA, KS 67220-1776
(316) 347-6633
(316) 744-0714
Mailing address
PO BOX 20803, WICHITA, KS 67208-6803
(316) 347-6633
(316) 744-0714
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
85352
KS
253Z00000X
In Home Supportive Care Agency
85352
KS
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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