Provider Demographics
NPI:1629831805
Name:KKC HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:KKC HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:NOUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-703-3030
Mailing Address - Street 1:525 EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-1934
Mailing Address - Country:US
Mailing Address - Phone:267-703-3030
Mailing Address - Fax:267-703-3031
Practice Address - Street 1:1012 W CHELTENHAM AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19126-2314
Practice Address - Country:US
Practice Address - Phone:267-703-3030
Practice Address - Fax:267-703-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility