Humboldt Assisted Living, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

100352910A Issued in KS

Legal business name

HUMBOLDT ASSISTED LIVING, LLC

Doing business as

Arrowood Lane

Practice address

615 Franklin St
Humboldt, KS 66748-1011

Phone

(620) 473-3456

Fax

(620) 473-2299

NPI assigned

Mar 18, 2007

Last updated

Jun 12, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jean L Wilcox

Title

Management Company Representative

Phone

(402) 898-1079

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Arrowood Lane Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434067200000",
    "number": "1164546024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 FRANKLIN ST",
            "city": "HUMBOLDT",
            "state": "KS",
            "postal_code": "667481011",
            "telephone_number": "620-473-3456",
            "fax_number": "620-473-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FRANKLIN ST",
            "city": "HUMBOLDT",
            "state": "KS",
            "postal_code": "667481011",
            "telephone_number": "620-473-3456",
            "fax_number": "620-473-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-18",
        "last_updated": "2015-06-12",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGEMENT COMPANY REPRESENTATIVE",
        "authorized_official_telephone_number": "402-898-1079"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "KS",
            "license": "100352910A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100352910A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arrowood Lane",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Michael Sean McReynolds, D.D.S.
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• Home Health Agency in Humboldt, KS
• Providers in Humboldt, KS by specialty
• Home Health Agency in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.