Healthcare Provider Details

I. General information

NPI: 1124427596
Provider Name (Legal Business Name): KP CARE GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 01/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 THONOTOSASSA RD 108
PLANT CITY FL
33563-1464
US

IV. Provider business mailing address

2505 THONOTOSASSA RD #108
PLANT CITY FL
33563-1464
US

V. Phone/Fax

Practice location:
  • Phone: 813-365-3534
  • Fax: 888-752-0242
Mailing address:
  • Phone: 813-365-3534
  • Fax: 888-752-0242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ERIKA CARTER
Title or Position: PRESIDENT
Credential:
Phone: 813-365-3534