Healthcare Provider Details

I. General information

NPI: 1821709197
Provider Name (Legal Business Name): CK INCLUSIVE HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 12/08/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 14TH ST STE 2136
PLANO TX
75074-6459
US

IV. Provider business mailing address

2100 14TH STREET STE 107 #2136
PLANO TX
75074
US

V. Phone/Fax

Practice location:
  • Phone: 972-836-6136
  • Fax:
Mailing address:
  • Phone: 972-836-6136
  • 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 Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: HARRIET KIBUNYI
Title or Position: OWNER
Credential: RN
Phone: 972-836-6136