Provider Demographics
NPI:1619279445
Name:KARE ONE DEVELOPMENTAL SERVICES, LLC
Entity Type:Organization
Organization Name:KARE ONE DEVELOPMENTAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LA'KRISHNA
Authorized Official - Middle Name:SARADA
Authorized Official - Last Name:HOLZENDORF-COUNCIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-506-3599
Mailing Address - Street 1:13722 GENTLE WOODS AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-2739
Mailing Address - Country:US
Mailing Address - Phone:813-506-3858
Mailing Address - Fax:
Practice Address - Street 1:13722 GENTLE WOODS AVE
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-2739
Practice Address - Country:US
Practice Address - Phone:813-506-3858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health