Humboldt Assisted Living, LLC

Organization Active NPI Home Health Agency · Humboldt, KS

NPI 1164546024 · NPPES record last updated Jun 12, 2015

Key facts

NPI
1164546024
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
100352910A (KS)
Legal business name
HUMBOLDT ASSISTED LIVING, LLC
Practice address
615 Franklin St
Humboldt, KS 66748-1011
Phone
(620) 473-3456
Fax
(620) 473-2299
NPI assigned
Mar 18, 2007
Organization subpart
No

Authorized official

Name
Jean L Wilcox
Title
Management Company Representative
Phone
(402) 898-1079

National Provider Directory

Locations

615 Franklin St
Humboldt, KS 66748
Phone (620) 473-3456

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 100352910A KS Yes

Addresses

Primary practice location

615 Franklin St
Humboldt, KS 66748-1011

Mailing address

615 Franklin St
Humboldt, KS 66748-1011
Phone (620) 473-3456

Other identifiers

IdentifierTypeStateIssuer
100352910AMedicaidKS

Other names

  • Arrowood Lane Doing business as

Other providers in Humboldt, KS

All providers in Humboldt, KS · Home Health Agency in Kansas

Sources for this page

Verify at the official NPI Registry.