Healthcare Provider Details

I. General information

NPI: 1659290591
Provider Name (Legal Business Name): K&M KARE HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 JAMISON ST
NEWARK DE
19713-1622
US

IV. Provider business mailing address

62 LAUREL ST
WOODBURY NJ
08096-2534
US

V. Phone/Fax

Practice location:
  • Phone: 856-287-6525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KEELAN Y VICTOR
Title or Position: OWNER
Credential:
Phone: 856-287-6525