MEDICARE: KINSHIP HOME HEALTH CARE LLC.

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

General Provider Information

NPI Number	:	1366054066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINSHIP HOME HEALTH CARE LLC.

Provider Business Mailing Address
First Line	:	430 HIGH ST APT 3
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23704-3650
Country	:	US
Telephone Number	:	757-739-0986
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 E CITY HALL AVE STE 355
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-1724
Country	:	US
Telephone Number	:	757-739-0986
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ ADMINISTRATOR
Name	:	MR. ANTHONY DRAKE
Credential	:
Telephone Number	:	757-739-0986

Provider Enumeration Date	:	08/24/2020
Last Update Date	:	02/18/2021

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