Provider Demographics
NPI:1023362779
Name:KAL HOME HEALTH INC
Entity Type:Organization
Organization Name:KAL HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RATLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-436-6179
Mailing Address - Street 1:302 N POCOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:POCOLA
Mailing Address - State:OK
Mailing Address - Zip Code:74902-3102
Mailing Address - Country:US
Mailing Address - Phone:918-436-6179
Mailing Address - Fax:918-436-6041
Practice Address - Street 1:302 N POCOLA BLVD
Practice Address - Street 2:
Practice Address - City:POCOLA
Practice Address - State:OK
Practice Address - Zip Code:74902-3102
Practice Address - Country:US
Practice Address - Phone:918-436-6179
Practice Address - Fax:918-436-6041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200529600 AMedicaid
37-7770Medicare PIN