Organization
PROACTIVE ASSOCIATES, LLC
Active
Parent organization
PHOENIX HOME CARE, INC.
Other names
Phoenix Home Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX HOME CARE, INC.
Authorized official
GEORGE SCOTT HERMAN (PRESIDENT & SECRETARY)
(512) 632-7156
Entity
Organization
Contact information
Practice address
3450 N ROCK ROAD, 213, WICHITA, KS 67226-1352
(316) 688-5511
(316) 688-1081
Mailing address
2450 N ROCK ROAD, SUITE # 213, ATTN: DEBRA MULLEN, WICHITA, KS 67060
(316) 688-5511
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
A087065
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100242630E
—
KS
05
—
100289090A
—
KS
05
—
100289090B
—
KS
Enumeration date
06/07/2007
Last updated
12/08/2021
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