Provider Demographics
NPI:1740768415
Name:KEVIN&JEAN,INC.
Entity Type:Organization
Organization Name:KEVIN&JEAN,INC.
Other - Org Name:ACTIKARE OF SW FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-940-5428
Mailing Address - Street 1:9990 COCONUT RD
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:34135-8488
Mailing Address - Country:US
Mailing Address - Phone:239-940-5428
Mailing Address - Fax:
Practice Address - Street 1:9990 COCONUT RD
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:34135-8488
Practice Address - Country:US
Practice Address - Phone:239-940-5428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty