Provider Demographics
NPI:1114148004
Name:KKES INC
Entity Type:Organization
Organization Name:KKES INC
Other - Org Name:UNIFIED HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOLKEMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BS
Authorized Official - Phone:231-830-9030
Mailing Address - Street 1:493 W NORTON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3748
Mailing Address - Country:US
Mailing Address - Phone:231-830-9030
Mailing Address - Fax:231-830-9032
Practice Address - Street 1:493 W NORTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-3748
Practice Address - Country:US
Practice Address - Phone:231-830-9030
Practice Address - Fax:231-830-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-9100Medicaid