Provider Demographics
NPI:1922342450
Name:MKKC CORP.
Entity Type:Organization
Organization Name:MKKC CORP.
Other - Org Name:GRISWOLD HOME CARE NORTH & EAST COLLIN CO., LAKE RAY HUBBARD, TX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:G
Authorized Official - Last Name:ODEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-914-8144
Mailing Address - Street 1:6841 VIRGINIA PKWY
Mailing Address - Street 2:SUITE 103-168
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5710
Mailing Address - Country:US
Mailing Address - Phone:214-914-8144
Mailing Address - Fax:214-975-1270
Practice Address - Street 1:3428 ESTES PARK LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2688
Practice Address - Country:US
Practice Address - Phone:214-914-8144
Practice Address - Fax:214-975-1270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care