Provider Demographics
NPI:1962977017
Name:OURKANSAS GUARDIAN LLC
Entity type:Organization
Organization Name:OURKANSAS GUARDIAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MR
Authorized Official - First Name:SIEGFRIED
Authorized Official - Middle Name:
Authorized Official - Last Name:MBOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-448-4250
Mailing Address - Street 1:9415 E HARRY ST, STE 605
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207
Mailing Address - Country:US
Mailing Address - Phone:316-448-4250
Mailing Address - Fax:316-219-5849
Practice Address - Street 1:9415 E HARRY ST, STE 605
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207
Practice Address - Country:US
Practice Address - Phone:316-448-4250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based