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Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICKI HOELTING (EXECUTIVE DIRECTOR)
(316) 265-1700
Entity
Organization

Contact information

Practice address
149 S RIDGE RD, WICHITA, KS 67209-2110
(316) 265-1700
(316) 682-0624
Mailing address
149 S RIDGE RD, WICHITA, KS 67209-2110
(316) 265-1700
(316) 682-0624

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
KS
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100009430A
KS
Enumeration date
09/20/2006
Last updated
08/31/2011
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