Provider Demographics
NPI:1992957401
Name:SEEDS OF HOPE HOME HEALTH AGENCY
Entity type:Organization
Organization Name:SEEDS OF HOPE HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-233-2600
Mailing Address - Street 1:3134 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-3920
Mailing Address - Country:US
Mailing Address - Phone:913-233-2600
Mailing Address - Fax:913-371-0504
Practice Address - Street 1:3134 STATE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-3920
Practice Address - Country:US
Practice Address - Phone:913-233-2600
Practice Address - Fax:913-371-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA105057251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100419880AMedicaid
KSA105057OtherSTATE OF KANSAS HOME HEALTH CARE AGENCY
KS100397540AMedicaid