Provider Demographics
NPI:1023358942
Name:MCKENNEYCARE, LLC
Entity Type:Organization
Organization Name:MCKENNEYCARE, LLC
Other - Org Name:MCKENNEY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MCKENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:JD, MPH
Authorized Official - Phone:239-325-2273
Mailing Address - Street 1:999 VANDERBILT BEACH RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-3512
Mailing Address - Country:US
Mailing Address - Phone:239-325-2273
Mailing Address - Fax:239-325-5001
Practice Address - Street 1:999 VANDERBILT BEACH RD STE 200
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-3512
Practice Address - Country:US
Practice Address - Phone:239-325-2273
Practice Address - Fax:239-325-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health