Provider Demographics
NPI:1760917389
Name:K&K HEALTHCARE SERVICE
Entity Type:Organization
Organization Name:K&K HEALTHCARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SYMBU
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:267-670-9477
Mailing Address - Street 1:2805 SAXTON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2403
Mailing Address - Country:US
Mailing Address - Phone:267-670-9477
Mailing Address - Fax:
Practice Address - Street 1:2805 SAXTON RD STE 2
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19114-2403
Practice Address - Country:US
Practice Address - Phone:267-670-9477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care