Healthcare Provider Details

I. General information

NPI: 1871334763
Provider Name (Legal Business Name): KINSEY KARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3954 JACKSON ST
GARY IN
46408-2750
US

IV. Provider business mailing address

816 SCHOEN CT APT G
CARMEL IN
46032-1567
US

V. Phone/Fax

Practice location:
  • Phone: 317-502-5533
  • Fax:
Mailing address:
  • Phone: 317-502-5533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: YVETTE WILLIAMS
Title or Position: OWNER
Credential:
Phone: 317-502-5533