Provider Demographics
NPI:1114160843
Name:KIDIMAK HOMEHEALTH SERVICES
Entity Type:Organization
Organization Name:KIDIMAK HOMEHEALTH SERVICES
Other - Org Name:SENASE HOMEHEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:BITAH
Authorized Official - Last Name:MAKIA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:972-359-0754
Mailing Address - Street 1:1216 VINELAND CT
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-5302
Mailing Address - Country:US
Mailing Address - Phone:972-359-0754
Mailing Address - Fax:
Practice Address - Street 1:1216 VINELAND CT
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-5302
Practice Address - Country:US
Practice Address - Phone:972-359-0754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801096065251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health