Provider Demographics
NPI:1174007439
Name:KULA HOME & HEALTH
Entity Type:Organization
Organization Name:KULA HOME & HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-740-3826
Mailing Address - Street 1:1909 ENFIELD CT
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-7417
Mailing Address - Country:US
Mailing Address - Phone:832-740-3826
Mailing Address - Fax:
Practice Address - Street 1:1909 ENFIELD CT
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-7417
Practice Address - Country:US
Practice Address - Phone:832-740-3826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care