Provider Demographics
NPI:1205978244
Name:MT. HOPE HOME HEALTH SERVICES
Entity type:Organization
Organization Name:MT. HOPE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KISSICK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:316-667-2431
Mailing Address - Street 1:704 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:KS
Mailing Address - Zip Code:67108-9408
Mailing Address - Country:US
Mailing Address - Phone:316-667-2431
Mailing Address - Fax:316-661-2352
Practice Address - Street 1:704 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOPE
Practice Address - State:KS
Practice Address - Zip Code:67108-9408
Practice Address - Country:US
Practice Address - Phone:316-667-2431
Practice Address - Fax:316-661-2352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-087-048251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health