Provider Demographics
NPI:1679910376
Name:INTERIM HEALTHCARE OF KANSAS CITY, INC.
Entity type:Organization
Organization Name:INTERIM HEALTHCARE OF KANSAS CITY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GREWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-381-3100
Mailing Address - Street 1:10977 GRANADA LN
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1468
Mailing Address - Country:US
Mailing Address - Phone:913-381-3100
Mailing Address - Fax:913-642-5683
Practice Address - Street 1:3131 S STATE ROUTE 291 STE C
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2645
Practice Address - Country:US
Practice Address - Phone:816-420-0533
Practice Address - Fax:816-420-0494
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE OF KANSAS CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-04
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO26-1653OtherCCN