MEDICARE: KALEO SUPPORTS, 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	251S00000X	Community/Behavioral Health Agency
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1669100897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KALEO SUPPORTS, INC.

Provider Business Mailing Address
First Line	:	3718 GOLFVIEW RD
Second Line	:
City	:	HOPE MILLS
State	:	NC
Zip	:	28348-2818
Country	:	US
Telephone Number	:	910-322-2755
Fax Number	:

Provider Business Practice Location Address
First Line	:	152 EDUCATION DR
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-9804
Country	:	US
Telephone Number	:	910-630-2255
Fax Number	:	910-339-2808

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NANCY SZYMKOWIAK
Credential	:
Telephone Number	:	910-630-2255

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	06/12/2023

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