Healthcare Provider Details

I. General information

NPI: 1437370921
Provider Name (Legal Business Name): KSC HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W VETERANS BLVD STE A
PALMVIEW TX
78572-7081
US

IV. Provider business mailing address

1101 W VETERANS BLVD STE A
PALMVIEW TX
78572-7081
US

V. Phone/Fax

Practice location:
  • Phone: 956-585-7266
  • Fax: 956-585-7388
Mailing address:
  • Phone: 956-585-7266
  • Fax: 956-585-7388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number011490
License Number StateTX

VIII. Authorized Official

Name: MARIE STFLEUR
Title or Position: PRESIDENT
Credential:
Phone: 956-585-7266