Provider Demographics
NPI:1134812712
Name:KAZE HOME CARE LLC
Entity type:Organization
Organization Name:KAZE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZU
Authorized Official - Middle Name:
Authorized Official - Last Name:BAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-750-3379
Mailing Address - Street 1:3214 E PAULDING RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46816-4515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3214 E PAULDING RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46816-4515
Practice Address - Country:US
Practice Address - Phone:260-750-3379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care