Provider Demographics
NPI:1477214252
Name:KS HEALTHCARE
Entity Type:Organization
Organization Name:KS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAHOGANI
Authorized Official - Middle Name:
Authorized Official - Last Name:MADRIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-318-1420
Mailing Address - Street 1:PO BOX 3034
Mailing Address - Street 2:
Mailing Address - City:COLORADO CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86021-3034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:60 N CENTRAL ST
Practice Address - Street 2:
Practice Address - City:COLORADO CITY
Practice Address - State:AZ
Practice Address - Zip Code:86021-6134
Practice Address - Country:US
Practice Address - Phone:801-318-1420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based