Provider Demographics
NPI:1245108919
Name:KMA CARE SERVICES LLC
Entity type:Organization
Organization Name:KMA CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SANOGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-200-0920
Mailing Address - Street 1:1921 FERENTZ TRCE
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-3676
Mailing Address - Country:US
Mailing Address - Phone:678-200-0920
Mailing Address - Fax:
Practice Address - Street 1:2201 HUNTER RIDGE LN
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-3736
Practice Address - Country:US
Practice Address - Phone:678-200-0920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-24
Last Update Date:2025-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251S00000XAgenciesCommunity/Behavioral Health
No251G00000XAgenciesHospice Care, Community Based
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
No251J00000XAgenciesNursing Care