MEDICARE: KINDLY DIRECT 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1821749052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINDLY DIRECT CARE LLC

Provider Business Mailing Address
First Line	:	1700 AVE OF THE STATES STE 204
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4608
Country	:	US
Telephone Number	:	732-218-2588
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 AVE OF THE STATES STE 204
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4608
Country	:	US
Telephone Number	:	732-218-2588
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	BELLA GANZVI
Credential	:
Telephone Number	:	732-267-4832

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	11/20/2025

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