Healthcare Provider Details

I. General information

NPI: 1144926015
Provider Name (Legal Business Name): KIKU HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MORRIS AVE STE 200
UNION NJ
07083-5675
US

IV. Provider business mailing address

2500 MORRIS AVE STE 200
UNION NJ
07083-5675
US

V. Phone/Fax

Practice location:
  • Phone: 414-458-1263
  • Fax:
Mailing address:
  • Phone: 414-458-1263
  • Fax:

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PRINCESS AGI
Title or Position: CO-OWNER/DON
Credential:
Phone: 414-458-1263