Provider Demographics
NPI:1013801844
Name:ICT HOME HEALTH, LLC
Entity type:Organization
Organization Name:ICT HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-733-2645
Mailing Address - Street 1:324 W CENTRAL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-9694
Mailing Address - Country:US
Mailing Address - Phone:316-448-1274
Mailing Address - Fax:316-733-0995
Practice Address - Street 1:324 W CENTRAL AVE STE D
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-9694
Practice Address - Country:US
Practice Address - Phone:316-448-1274
Practice Address - Fax:316-733-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSA008016OtherHOME HEALTH LICENSE