Healthcare Provider Details

I. General information

NPI: 1538833967
Provider Name (Legal Business Name): KAREN HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 BLACKHAWK HILLS CT
ROCK ISLAND IL
61201-6935
US

IV. Provider business mailing address

14 BLACKHAWK HILLS CT
ROCK ISLAND IL
61201-6935
US

V. Phone/Fax

Practice location:
  • Phone: 309-519-3433
  • Fax:
Mailing address:
  • Phone: 309-519-3433
  • Fax:

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: HESS HTOO SEMUTUSHI
Title or Position: MANAGER
Credential:
Phone: 309-519-3433