Provider Demographics
NPI:1396036307
Name:KQM INC
Entity Type:Organization
Organization Name:KQM INC
Other - Org Name:VISITING ANGELS HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SESHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-647-6770
Mailing Address - Street 1:7209 US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1901
Mailing Address - Country:US
Mailing Address - Phone:859-647-6770
Mailing Address - Fax:
Practice Address - Street 1:7209 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1901
Practice Address - Country:US
Practice Address - Phone:859-647-6770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500044253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY500044OtherPERSONAL SERVICES AGENCY CERTIFICATION