Provider Demographics
NPI:1710051370
Name:KACYS KARE LLC
Entity Type:Organization
Organization Name:KACYS KARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KACYNDA
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:267-973-6325
Mailing Address - Street 1:6320 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-2010
Mailing Address - Country:US
Mailing Address - Phone:267-973-2632
Mailing Address - Fax:
Practice Address - Street 1:6320 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-2010
Practice Address - Country:US
Practice Address - Phone:267-973-2632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9968183251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health