Provider Demographics
NPI:1720391014
Name:KADIEKARE COMPANION HOME CARE
Entity Type:Organization
Organization Name:KADIEKARE COMPANION HOME CARE
Other - Org Name:FESTACBUILDING CONSTRUCTORS, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-877-2211
Mailing Address - Street 1:2828 FOREST LN STE 1011
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7570
Mailing Address - Country:US
Mailing Address - Phone:972-484-2626
Mailing Address - Fax:972-853-7410
Practice Address - Street 1:2828 FOREST LN STE 1011
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7570
Practice Address - Country:US
Practice Address - Phone:972-484-2626
Practice Address - Fax:972-853-7410
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FESTAC BUILDING CONSTRUCTORS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02334972343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)