Healthcare Provider Details

I. General information

NPI: 1225824881
Provider Name (Legal Business Name): KEPA HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PLEASANT ST STE 209
WORCESTER MA
01609-3213
US

IV. Provider business mailing address

101 PLEASANT ST STE 209
WORCESTER MA
01609-3213
US

V. Phone/Fax

Practice location:
  • Phone: 774-420-8144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. KENNEY KAIRU
Title or Position: OWNER
Credential: DNP, MBA
Phone: 774-420-8144