=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457129777
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KADIAN HOMECARE SOLUTION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2023
-----------------------------------------------------
Last Update Date | 12/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2924 N 17TH STREET
-----------------------------------------------------
City | PHILA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-928-9396
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2924 N 17TH STREET
-----------------------------------------------------
City | PHILA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-928-9396
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KADIAN PAUL
-----------------------------------------------------
Credential | CNA
-----------------------------------------------------
Telephone | 267-928-9396
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------