Healthcare Provider Details

I. General information

NPI: 1649864406
Provider Name (Legal Business Name): KASACARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 STRAFFORD AVE STE 202
WAYNE PA
19087-3317
US

IV. Provider business mailing address

PO BOX 64764
SOUDERTON PA
18964-0764
US

V. Phone/Fax

Practice location:
  • Phone: 610-254-0600
  • Fax: 855-823-8280
Mailing address:
  • Phone: 610-937-2736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL DAVID RYAN SR.
Title or Position: LEGACY (V.P. BUSINESS DEVELOPMENT)
Credential:
Phone: 610-937-2736