Provider Demographics
NPI:1215114186
Name:CARRIE'S HELPING HANDS
Entity type:Organization
Organization Name:CARRIE'S HELPING HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOODE
Authorized Official - Suffix:
Authorized Official - Credentials:ADN
Authorized Official - Phone:620-926-0305
Mailing Address - Street 1:PO BOX 946
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-0946
Mailing Address - Country:US
Mailing Address - Phone:620-926-0305
Mailing Address - Fax:620-331-4766
Practice Address - Street 1:621 S 2ND ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-4311
Practice Address - Country:US
Practice Address - Phone:620-926-0305
Practice Address - Fax:620-331-4766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA063011251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health