MEDICARE: KQ HOME HEALTHCARE, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1588218937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KQ HOME HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	930 MINNESOTA AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66101-2611
Country	:	US
Telephone Number	:	402-943-7836
Fax Number	:

Provider Business Practice Location Address
First Line	:	930 MINNESOTA AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66101-2611
Country	:	US
Telephone Number	:	402-943-7836
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT/TREASURER
Name	:	EH WAH
Credential	:
Telephone Number	:	913-313-5863

Provider Enumeration Date	:	07/24/2019
Last Update Date	:	07/24/2019

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Directions to “KQ HOME HEALTHCARE, INC ” Practice Location

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