Provider Demographics
NPI:1598902397
Name:KEN-CARE
Entity Type:Organization
Organization Name:KEN-CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-373-9233
Mailing Address - Street 1:102 NE 10TH AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-2300
Mailing Address - Country:US
Mailing Address - Phone:352-373-9233
Mailing Address - Fax:352-379-9530
Practice Address - Street 1:102 NE 10TH AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-2300
Practice Address - Country:US
Practice Address - Phone:352-373-9233
Practice Address - Fax:352-379-9530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCS228096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health