Provider Demographics
NPI:1598858870
Name:KINGLY HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:KINGLY HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILIP
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-586-4560
Mailing Address - Street 1:1219 STEWART DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-7354
Mailing Address - Country:US
Mailing Address - Phone:469-586-4560
Mailing Address - Fax:
Practice Address - Street 1:1219 STEWART DR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-7354
Practice Address - Country:US
Practice Address - Phone:469-586-4560
Practice Address - Fax:468-586-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-01
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009978251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX IDENTIFICATION
TX=========OtherTAX IDENTIFICATION