Provider Demographics
NPI:1245922046
Name:KENDERED CARE
Entity type:Organization
Organization Name:KENDERED CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLAUME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-647-8716
Mailing Address - Street 1:521 NEW HORIZONS LOOP
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-4511
Mailing Address - Country:US
Mailing Address - Phone:305-647-8716
Mailing Address - Fax:
Practice Address - Street 1:712 AVENUE L SE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4220
Practice Address - Country:US
Practice Address - Phone:863-320-0058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health