MEDICARE: CK INCLUSIVE HOME HEALTH CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3747A0650X	Attendant Care Provider
2	3747P1801X	Personal Care Attendant
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1821709197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CK INCLUSIVE HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	2100 14TH STREET STE 107
Second Line	:	#2136
City	:	PLANO
State	:	TX
Zip	:	75074
Country	:	US
Telephone Number	:	972-836-6136
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 14TH ST STE 2136
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-6459
Country	:	US
Telephone Number	:	972-836-6136
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HARRIET KIBUNYI
Credential	:	RN
Telephone Number	:	972-836-6136

Provider Enumeration Date	:	12/08/2022
Last Update Date	:	12/08/2022

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Directions to “CK INCLUSIVE HOME HEALTH CARE LLC ” Practice Location

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