MEDICARE: KIND HUMAN SENIOR 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	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1386410694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIND HUMAN SENIOR CARE, LLC

Provider Business Mailing Address
First Line	:	702 DONALDSON AVE STE 201
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-4851
Country	:	US
Telephone Number	:	830-253-0014
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 DONALDSON AVE STE 201
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-4851
Country	:	US
Telephone Number	:	830-253-0014
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN OMEALEY
Credential	:
Telephone Number	:	830-253-0014

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	02/28/2024

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