MEDICARE: KENO SENIOR SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	57-186865	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144425091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENO SENIOR SERVICES INC

Provider Business Mailing Address
First Line	:	5335 FAR HILLS AVE
Second Line	:	SUITE 107
City	:	DAYTON
State	:	OH
Zip	:	45429-2350
Country	:	US
Telephone Number	:	937-432-6475
Fax Number	:	937-432-6916

Provider Business Practice Location Address
First Line	:	5335 FAR HILLS AVE
Second Line	:	SUITE 107
City	:	DAYTON
State	:	OH
Zip	:	45429-2350
Country	:	US
Telephone Number	:	937-432-6475
Fax Number	:	937-432-6916

Authorized Official
Title or Position	:	OWNER- PRESIDENT
Name	:	MR. KEN OLSEN
Credential	:
Telephone Number	:	937-432-6475

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	08/22/2020

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Directions to “KENO SENIOR SERVICES INC ” Practice Location

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