MEDICARE: KKIRK HOLDINGS CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1730410739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KKIRK HOLDINGS CORPORATION

Provider Business Mailing Address
First Line	:	9225 KATY FWY STE 112
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1508
Country	:	US
Telephone Number	:	832-460-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9225 KATY FWY STE 202
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1509
Country	:	US
Telephone Number	:	832-460-2000
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KARENA KIRK
Credential	:
Telephone Number	:	832-460-2000

Provider Enumeration Date	:	01/15/2010
Last Update Date	:	05/20/2014

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