Provider Demographics
NPI:1770032583
Name:KM HOME CARE, LLC
Entity Type:Organization
Organization Name:KM HOME CARE, LLC
Other - Org Name:KM HOME CARE LLC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:V
Authorized Official - Last Name:EXPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-310-5591
Mailing Address - Street 1:4861 S ORANGE AVE UNIT 4A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6949
Mailing Address - Country:US
Mailing Address - Phone:786-310-5591
Mailing Address - Fax:786-310-5592
Practice Address - Street 1:2100 W 76TH ST STE 407A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5504
Practice Address - Country:US
Practice Address - Phone:786-285-0947
Practice Address - Fax:786-310-5592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251E00000XAgenciesHome Health