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NPI Code Detail

MEDICARE: KIKIS HOME CARE

MEDICARE: KIKIS HOME CARE
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
1376J00000XHomemaker
2385H00000XRespite Care
3253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1992557631
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIKIS HOME CARE
Provider Business Mailing Address
First Line : 4209 W PAT ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57107-1839
Country : US
Telephone Number : 605-400-3246
Fax Number :
Provider Business Practice Location Address
First Line : 4209 W PAT ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57107-1839
Country : US
Telephone Number : 605-400-3246
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF OPPERATION
Name : MUSTAFA CHANSA KALOMBO
Credential :
Telephone Number : 605-400-3246
Provider Enumeration Date : 04/04/2024
Last Update Date : 04/04/2024

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Directions to “KIKIS HOME CARE ” Practice Location

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