Provider Demographics
NPI:1225623937
Name:K C HOME HEALTH II LLC
Entity Type:Organization
Organization Name:K C HOME HEALTH II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:O
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-992-7867
Mailing Address - Street 1:1813 SHORE DR S STE 5
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-4701
Mailing Address - Country:US
Mailing Address - Phone:813-525-3878
Mailing Address - Fax:
Practice Address - Street 1:1813 SHORE DR S STE 5
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-4701
Practice Address - Country:US
Practice Address - Phone:813-525-3878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health