Healthcare Provider Details

I. General information

NPI: 1790134765
Provider Name (Legal Business Name): KDH HOME HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 COLLINS RD NE STE 101
CEDAR RAPIDS IA
52402-3167
US

IV. Provider business mailing address

373 COLLINS RD NE STE 101
CEDAR RAPIDS IA
52402-3167
US

V. Phone/Fax

Practice location:
  • Phone: 319-247-0400
  • Fax: 319-377-5334
Mailing address:
  • Phone: 319-247-0400
  • Fax: 319-377-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. KAREN HUBER
Title or Position: PRESIDENT
Credential:
Phone: 319-247-0400