Healthcare Provider Details

I. General information

NPI: 1114881356
Provider Name (Legal Business Name): HOME CARE KIMISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1690 WATERTOWER PL STE 100
EAST LANSING MI
48823-8045
US

IV. Provider business mailing address

1690 WATERTOWER PL STE 100
EAST LANSING MI
48823-8045
US

V. Phone/Fax

Practice location:
  • Phone: 317-418-7790
  • Fax:
Mailing address:
  • Phone: 317-418-7790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIMBERLY DENISE COLEMAN
Title or Position: PRESIDENT
Credential:
Phone: 317-982-9585