Healthcare Provider Details

I. General information

NPI: 1093282931
Provider Name (Legal Business Name): KMK CARE ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 J ST STE 300
SACRAMENTO CA
95816-4849
US

IV. Provider business mailing address

11815 TRAILRIDER DR
ELK GROVE CA
95624-9397
US

V. Phone/Fax

Practice location:
  • Phone: 916-655-4663
  • Fax: 916-415-3544
Mailing address:
  • Phone: 916-524-7020
  • Fax: 916-415-3544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KIRANDIP KAUR SAMRAN
Title or Position: CEO
Credential:
Phone: 916-524-7020