Provider Demographics
NPI:1326446261
Name:KMG HOMECARE UNLIMITED, LLC
Entity Type:Organization
Organization Name:KMG HOMECARE UNLIMITED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ALLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:765-639-8150
Mailing Address - Street 1:307 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-4649
Mailing Address - Country:US
Mailing Address - Phone:765-393-1228
Mailing Address - Fax:765-393-1956
Practice Address - Street 1:307 E 38TH ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-4649
Practice Address - Country:US
Practice Address - Phone:765-393-1228
Practice Address - Fax:765-393-1956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN14-013514-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health