Healthcare Provider Details

I. General information

NPI: 1396680484
Provider Name (Legal Business Name): KP HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 SAGER PL
HILLSIDE NJ
07205-1024
US

IV. Provider business mailing address

46 SAGER PL
HILLSIDE NJ
07205-1024
US

V. Phone/Fax

Practice location:
  • Phone: 908-358-6250
  • Fax:
Mailing address:
  • Phone: 908-358-6250
  • 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: PAUL IYAHEN
Title or Position: OWNER/ ADMINISTRATOR
Credential:
Phone: 908-358-6250