Provider Demographics
NPI:1548907686
Name:KENAN HOME CARE LLC
Entity type:Organization
Organization Name:KENAN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-285-0067
Mailing Address - Street 1:4358 OLD SHELL RD STE B-195
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-2050
Mailing Address - Country:US
Mailing Address - Phone:251-285-0067
Mailing Address - Fax:256-886-3089
Practice Address - Street 1:5959 MONTFORT RD S
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3555
Practice Address - Country:US
Practice Address - Phone:251-285-0067
Practice Address - Fax:251-285-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care