Organization
CENTERWELL CERTIFIED HEALTHCARE CORP.
Active
Other names
CENTERWELL HOME HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(502) 895-4213
Entity
Organization
Contact information
Practice address
710 EXECUTIVE PARK, LOUISVILLE, KY 40207-4207
(502) 895-4213
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054236
G2
—
01
—
000013015J
G2
—
01
—
000028220
G2
—
05
—
1050333
—
KY
01
—
109673
G2
—
01
—
15324
G2
—
01
—
181090
G2
—
05
—
34000257
—
KY
05
—
34011569
—
KY
05
—
41056060
—
KY
05
—
42010561
—
KY
05
—
45344843
—
KY
01
—
505
G2
—
01
—
564395
G2
—
01
—
7405017
G2
—
01
—
9894
G2
—
Enumeration date
07/08/2006
Last updated
03/19/2024
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