Provider Demographics
NPI:1477383313
Name:4 KINGS HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:4 KINGS HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISABELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEMA
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:405-267-0040
Mailing Address - Street 1:11032 QUAIL CREEK RD STE 265
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-6208
Mailing Address - Country:US
Mailing Address - Phone:405-267-0040
Mailing Address - Fax:405-267-0042
Practice Address - Street 1:11032 QUAIL CREEK RD STE 265
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6208
Practice Address - Country:US
Practice Address - Phone:405-267-0040
Practice Address - Fax:405-267-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care