Provider Demographics
NPI:1922497437
Name:K&M ADVANCED CARE LLC
Entity Type:Organization
Organization Name:K&M ADVANCED CARE LLC
Other - Org Name:K&M ADVANCED CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:COFFEEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-585-0401
Mailing Address - Street 1:7905 W APPLETON AVE
Mailing Address - Street 2:104
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218
Mailing Address - Country:US
Mailing Address - Phone:414-585-0401
Mailing Address - Fax:
Practice Address - Street 1:7905 W APPLETON AVE
Practice Address - Street 2:104
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-4580
Practice Address - Country:US
Practice Address - Phone:414-585-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health