Provider Demographics
NPI:1164999819
Name:KALIBRA HOME CARE
Entity Type:Organization
Organization Name:KALIBRA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KERNAN
Authorized Official - Suffix:
Authorized Official - Credentials:ADN
Authorized Official - Phone:940-399-9197
Mailing Address - Street 1:275 W CAMPBELL RD STE 225
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3601
Mailing Address - Country:US
Mailing Address - Phone:614-746-5160
Mailing Address - Fax:
Practice Address - Street 1:275 W CAMPBELL RD STE 225
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3601
Practice Address - Country:US
Practice Address - Phone:614-746-5160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018210OtherTEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES