1467904805 NPI number — KELS IN-HOME SERVICES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467904805 NPI number — KELS IN-HOME SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KELS IN-HOME SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467904805
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7280 NW 87TH TER
Provider Second Line Business Mailing Address:
#210
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64153-3720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7280 NW 87TH TER
Provider Second Line Business Practice Location Address:
#210
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64153-3720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-799-8349
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2016

Additional Information

Authorized Official

Authorized Official Last Name:
JEAN-BAPTISTE
Authorized Official First Name:
KERLINE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/REGISTERED NURSE
Authorized Official Telephone Number:
816-799-8349

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0016940 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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