Healthcare Provider Details

I. General information

NPI: 1144018664
Provider Name (Legal Business Name): KERK HEALTHCARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 FALKIRK DR
WARNER ROBINS GA
31088-2151
US

IV. Provider business mailing address

903 FALKIRK DR
WARNER ROBINS GA
31088-2151
US

V. Phone/Fax

Practice location:
  • Phone: 919-587-7066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: EDNA ENYEJI
Title or Position: CEO
Credential:
Phone: 919-587-7066