Provider Demographics
NPI:1073753471
Name:KKACHE ENTERPRISES, INC
Entity Type:Organization
Organization Name:KKACHE ENTERPRISES, INC
Other - Org Name:KKACHE HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:IFEOMA
Authorized Official - Last Name:ELEBO-STINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-522-0860
Mailing Address - Street 1:10130 SHILOH CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-3522
Mailing Address - Country:US
Mailing Address - Phone:540-522-0860
Mailing Address - Fax:571-379-7784
Practice Address - Street 1:10130 SHILOH CT
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-3522
Practice Address - Country:US
Practice Address - Phone:540-522-0860
Practice Address - Fax:571-379-7784
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KKACHE ENTERPRISES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health