Kosciusko Home Care & Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

07-009511-1 Issued in IN

Legal business name

KOSCIUSKO HOME CARE & HOSPICE INC

Practice address

1515 Provident Dr
Suite 250
Warsaw, IN 46580-3294

Phone

(574) 372-3401

Fax

(574) 372-3415

NPI assigned

Apr 29, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Richard R Paczkowski

Title

Administrator

Phone

(574) 372-3401

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1861667941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 PROVIDENT DR",
            "address_2": "SUITE 250",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803294",
            "telephone_number": "574-372-3401",
            "fax_number": "574-372-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 PROVIDENT DR",
            "address_2": "SUITE 250",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803294",
            "telephone_number": "574-372-3401",
            "fax_number": "574-372-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSCIUSKO HOME CARE & HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "PACZKOWSKI",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "574-372-3401",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IN",
            "license": "07-009511-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200297120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesse R Kooistra, FNP
• Anna Danielle Koon, DDS
• Tracy Kimberly Koontz, RD
• Kosciusko County Health Department
• Kosciusko Family Healthcare, P.C.
• Kosciusko Home Care & Hospice Inc
• Kosciusko Medical Group LLC
• Christopher Michael Kowalski, MD
• Ashlee Kreft, MA
• Nancy Ann Kriner, QMA

• Community Based Hospice Care Agency in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Community Based Hospice Care Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.