=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669330155
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BKD PERSONAL ASSISTANCE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2026
-----------------------------------------------------
Last Update Date | 01/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5800 OLD PROVIDENCE RD
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28226-6872
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-887-0172
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5800 OLD PROVIDENCE RD
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28226-6872
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-887-0172
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSISTANT SECRETARY
-----------------------------------------------------
Name | ANNA MUNOZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 414-918-5443
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------