Provider Demographics
NPI:1417106006
Name:KENNEDY CARE
Entity Type:Organization
Organization Name:KENNEDY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MHSA
Authorized Official - Phone:734-657-3528
Mailing Address - Street 1:1310 SE MAYNARD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3615
Mailing Address - Country:US
Mailing Address - Phone:919-462-7003
Mailing Address - Fax:877-533-6177
Practice Address - Street 1:1310 SE MAYNARD RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3615
Practice Address - Country:US
Practice Address - Phone:919-462-7003
Practice Address - Fax:877-533-6177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health