MEDICARE: K AND R AMAZING PERSONAL CARE 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1427797414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K AND R AMAZING PERSONAL CARE INC

Provider Business Mailing Address
First Line	:	PO BOX 62262
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77205-2262
Country	:	US
Telephone Number	:	713-259-6470
Fax Number	:	713-583-6186

Provider Business Practice Location Address
First Line	:	5103 LANGLEY RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-2917
Country	:	US
Telephone Number	:	713-259-6470
Fax Number	:	713-583-6186

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KATHLEEN MOSBY
Credential	:
Telephone Number	:	713-259-6470

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	05/31/2022

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