Provider Demographics
NPI:1639647092
Name:KAIROS HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:KAIROS HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-433-2142
Mailing Address - Street 1:1130 E DONEGAN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-1918
Mailing Address - Country:US
Mailing Address - Phone:407-734-3888
Mailing Address - Fax:407-386-3133
Practice Address - Street 1:1130 E DONEGAN AVE STE 1
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1918
Practice Address - Country:US
Practice Address - Phone:407-734-3888
Practice Address - Fax:407-386-3133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100297800Medicaid