Provider Demographics
NPI:1316288863
Name:AT HOME ASSISTED CARE
Entity type:Organization
Organization Name:AT HOME ASSISTED CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRNBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-473-7007
Mailing Address - Street 1:2401 N SETH CHILD RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-8817
Mailing Address - Country:US
Mailing Address - Phone:785-473-7007
Mailing Address - Fax:785-370-0524
Practice Address - Street 1:2401 N SETH CHILD RD
Practice Address - Street 2:SUITE 140
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-8817
Practice Address - Country:US
Practice Address - Phone:785-473-7007
Practice Address - Fax:785-370-0524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA081009251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health