Healthcare Provider Details

I. General information

NPI: 1649857749
Provider Name (Legal Business Name): KAY HOME HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8639 ENGLESIDE OFFICE PARK STE A
ALEXANDRIA VA
22309-4132
US

IV. Provider business mailing address

5923 HIGHDALE CIR
ALEXANDRIA VA
22310-5422
US

V. Phone/Fax

Practice location:
  • Phone: 202-344-6434
  • Fax:
Mailing address:
  • Phone: 202-344-6434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: EMMANUEL CAHMIWA
Title or Position: OWNER
Credential:
Phone: 202-344-6434