Custom Care of Ellsworth, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

A027002 Issued in KS

Legal business name

CUSTOM CARE OF ELLSWORTH, INC

Practice address

802 N Maple St
Russell, KS 67665-1937

Phone

(785) 445-3500

Fax

(785) 445-3502

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Angela W Eddins

Title

President

Phone

(785) 445-3500

Specialties & licenses 1

Addresses

Other names 1

• Angels Care Home Health Doing business as

Locations

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1780600221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 HIGHWAY 1187",
            "address_2": "SUITE 203",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636124",
            "telephone_number": "817-469-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 N MAPLE ST",
            "city": "RUSSELL",
            "state": "KS",
            "postal_code": "676651937",
            "telephone_number": "785-445-3500",
            "fax_number": "785-445-3502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Elmhurst Blvd",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Salina",
            "state": "KS",
            "postal_code": "674017403",
            "country_code": "US",
            "telephone_number": "785-826-9600",
            "fax_number": "785-826-9611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CUSTOM CARE OF ELLSWORTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "EDDINS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-445-3500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "KS",
            "license": "A027002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angels Care Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Angels Care Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• County of Russell
• County of Russell
• Mikayla Jean Craver
• Holly Marie Creamer, BCBA
• Adam Crotty
• Eugene Merle Davidson, D.C.
• Emily J Decker, PA-C
• Holly Christina Decker, RBT
• Developmental Services of Northwest Kansas, Inc.
• Developmental Services of Northwest Kansas, Inc.

• Home Health Agency in Russell, KS
• Providers in Russell, 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 May 31, 2018; 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.