Organization
HOME BASE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BUNNY HIGGINS (EXECUTIVE DIRECTOR)
(913) 649-5700
Entity
Organization
Contact information
Practice address
7086 W 105TH ST, OVERLAND PARK, KS 66212-1803
(913) 649-5700
Mailing address
7086 W 105TH ST, OVERLAND PARK, KS 66212-1803
(913) 649-5700
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
35336422
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200004550A
PROVIDER
KS
Enumeration date
09/13/2013
Last updated
09/13/2013
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