Provider Demographics
NPI:1235945726
Name:HOLTON HOSPICE, LLC
Entity type:Organization
Organization Name:HOLTON HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMZEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-406-2867
Mailing Address - Street 1:11827 W 112TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2700
Mailing Address - Country:US
Mailing Address - Phone:913-296-7636
Mailing Address - Fax:
Practice Address - Street 1:1100 COLUMBINE DR
Practice Address - Street 2:
Practice Address - City:HOLTON
Practice Address - State:KS
Practice Address - Zip Code:66436-8841
Practice Address - Country:US
Practice Address - Phone:785-364-9617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based