Healthcare Provider Details

I. General information

NPI: 1891671632
Provider Name (Legal Business Name): KSCARES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 STONEHENGE BLVD
LIBERTY TWP OH
45044-9786
US

IV. Provider business mailing address

6355 STONEHENGE BLVD
LIBERTY TWP OH
45044-9786
US

V. Phone/Fax

Practice location:
  • Phone: 513-969-7377
  • Fax:
Mailing address:
  • Phone: 513-969-7377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. KUDAKWASHE SHUMBA
Title or Position: CEO
Credential:
Phone: 513-969-7377