Provider Demographics
NPI:1629094024
Name:KAMBELINE HOME HEALTH CARE SERVICES, LLC
Entity Type:Organization
Organization Name:KAMBELINE HOME HEALTH CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:KAMBELINE
Authorized Official - Last Name:OSEI-MOULD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-234-3177
Mailing Address - Street 1:515 CLEARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4808
Mailing Address - Country:US
Mailing Address - Phone:972-235-0072
Mailing Address - Fax:972-234-3177
Practice Address - Street 1:515 CLEARWOOD DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-4808
Practice Address - Country:US
Practice Address - Phone:972-235-0072
Practice Address - Fax:972-234-3177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0094390251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0094390OtherLICENSE NUMBER