Healthcare Provider Details

I. General information

NPI: 1538952940
Provider Name (Legal Business Name): KENMAR HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16228 OXLEY RD APT 104
SOUTHFIELD MI
48075
US

IV. Provider business mailing address

16228 OXLEY RD SUITE APT 104
SOUTHFIELD MI
48075
US

V. Phone/Fax

Practice location:
  • Phone: 313-455-7498
  • Fax: 520-423-3901
Mailing address:
  • Phone: 313-455-7498
  • Fax: 520-423-3901

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: MS. KENYA TERESA CALDWELL
Title or Position: OWNER
Credential:
Phone: 313-455-7498