Provider Demographics
NPI:1629261573
Name:KM CORPORATION
Entity Type:Organization
Organization Name:KM CORPORATION
Other - Org Name:HOME HELPERS/DIRECT LINK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-646-6400
Mailing Address - Street 1:4449 E DIABLO DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-5729
Mailing Address - Country:US
Mailing Address - Phone:928-646-6400
Mailing Address - Fax:928-646-6400
Practice Address - Street 1:4449 E DIABLO DR
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-5729
Practice Address - Country:US
Practice Address - Phone:928-646-6400
Practice Address - Fax:928-646-6400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health