1134159510 NPI number — GENTIVA HEALTH SERVICES (CERTIFIED), INC.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134159510 NPI number — GENTIVA HEALTH SERVICES (CERTIFIED), INC.

Employer Identification Number (EIN):

Provider Organization Name:

GENTIVA HEALTH SERVICES (CERTIFIED), INC.

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

KINDRED AT HOME

Provider Other Organization Name Type Code:

3

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1134159510

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

12/23/2015

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

12900 FOSTER ST STE 400

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

OVERLAND PARK

Provider Business Mailing Address State Name:

KS

Provider Business Mailing Address Postal Code:

66213-2696

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

4700 BAYOU BLVD STE 1C

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

PENSACOLA

Provider Business Practice Location Address State Name:

FL

Provider Business Practice Location Address Postal Code:

32503-2670

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

850-477-5800

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

07/03/2006

Authorized Official Last Name:

SCHWARTZ

Authorized Official First Name:

RUTH

Authorized Official Middle Name:

C

Authorized Official Title or Position:

ASSISTANT SECRETARY

Authorized Official Telephone Number:

913-814-2288

• Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 013100P . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 107937332 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 11225647902 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 070425 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 1016449 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 235397 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 6000055 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 2117447 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 113414024G . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 146544 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 2338051 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 11-3414024 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 080053 . This is a "G2" identifier . This identifiers is of the category "OTHER".
• Identifier: 112645333 . This is a "G2" identifier . This identifiers is of the category "OTHER".