Provider Demographics
NPI:1821632258
Name:KENAI PENINSULA HOME HEALTH LLC
Entity Type:Organization
Organization Name:KENAI PENINSULA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-260-4444
Mailing Address - Street 1:PO BOX 530
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-0530
Mailing Address - Country:US
Mailing Address - Phone:970-227-8811
Mailing Address - Fax:
Practice Address - Street 1:44332 STERLING HWY STE 42
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-8065
Practice Address - Country:US
Practice Address - Phone:907-260-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health