Provider Demographics
NPI:1245891035
Name:KIND HEART CAREGIVERS
Entity type:Organization
Organization Name:KIND HEART CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:KAILISSE
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-660-8004
Mailing Address - Street 1:10840 COTTONWOOD LANE APT 39
Mailing Address - Street 2:10840 COTTONWOOD LANE APT 39
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164
Mailing Address - Country:US
Mailing Address - Phone:402-660-8004
Mailing Address - Fax:402-500-3790
Practice Address - Street 1:10840 COTTONWOOD LANE APT 39
Practice Address - Street 2:10840 COTTONWOOD LANE APT 39
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164
Practice Address - Country:US
Practice Address - Phone:402-660-8004
Practice Address - Fax:402-500-3790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE65768477Medicaid