Provider Demographics
NPI:1124427596
Name:KP CARE GROUP, INC
Entity type:Organization
Organization Name:KP CARE GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-365-3534
Mailing Address - Street 1:2505 THONOTOSASSA RD
Mailing Address - Street 2:#108
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-1464
Mailing Address - Country:US
Mailing Address - Phone:813-365-3534
Mailing Address - Fax:888-752-0242
Practice Address - Street 1:2505 THONOTOSASSA RD
Practice Address - Street 2:108
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-1464
Practice Address - Country:US
Practice Address - Phone:813-365-3534
Practice Address - Fax:888-752-0242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015971000Medicaid