Provider Demographics
NPI:1851622724
Name:KENDELL KARE GROUP
Entity Type:Organization
Organization Name:KENDELL KARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF BOARD
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIUS
Authorized Official - Middle Name:K
Authorized Official - Last Name:RADFORD
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:404-434-2875
Mailing Address - Street 1:3458 JESSICA RUN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-6718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3458 JESSICA RUN
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-6718
Practice Address - Country:US
Practice Address - Phone:404-434-2875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-16
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17053233341048311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home