Provider Demographics
NPI:1306381918
Name:K & K HOME CARE LLC
Entity Type:Organization
Organization Name:K & K HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:718-930-4550
Mailing Address - Street 1:216 HALLADAY ST
Mailing Address - Street 2:APT 4
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-3300
Mailing Address - Country:US
Mailing Address - Phone:718-930-4550
Mailing Address - Fax:
Practice Address - Street 1:216 HALLADAY ST
Practice Address - Street 2:APT 4
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-3300
Practice Address - Country:US
Practice Address - Phone:718-930-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2087696253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care