Provider Demographics
NPI:1578141909
Name:KAYDOLLY HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:KAYDOLLY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADESINA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:401-330-0824
Mailing Address - Street 1:28 PADELFORD ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1714
Mailing Address - Country:US
Mailing Address - Phone:401-330-0804
Mailing Address - Fax:
Practice Address - Street 1:750 EAST AVE STE 17
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6245
Practice Address - Country:US
Practice Address - Phone:401-330-0824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health