Provider Demographics
NPI:1073956090
Name:KEMTESS HOME CARE SERVICES INC.
Entity Type:Organization
Organization Name:KEMTESS HOME CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:OMOWUNMI
Authorized Official - Last Name:ENEJOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-957-2343
Mailing Address - Street 1:3512 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7857
Mailing Address - Country:US
Mailing Address - Phone:214-957-2343
Mailing Address - Fax:
Practice Address - Street 1:3512 PONDEROSA DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-7857
Practice Address - Country:US
Practice Address - Phone:214-957-2343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014148251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX014148OtherSTATE OF TEXAS LICENCE NUMBER