Provider Demographics
NPI:1215358122
Name:KAMKEN CARE SERVICES LLC
Entity Type:Organization
Organization Name:KAMKEN CARE SERVICES LLC
Other - Org Name:JANELLE STOWERS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:314-731-1563
Mailing Address - Street 1:320 BROOKES DRIVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63042-2740
Mailing Address - Country:US
Mailing Address - Phone:314-731-1563
Mailing Address - Fax:314-667-3083
Practice Address - Street 1:320 BROOKES DR
Practice Address - Street 2:SUITE 205
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-2736
Practice Address - Country:US
Practice Address - Phone:314-731-1563
Practice Address - Fax:314-667-3083
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JANELLE STOWERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1578852521Medicaid