Provider Demographics
NPI:1700609179
Name:KANAMEE HOME HEALTHCARE SERVICES
Entity type:Organization
Organization Name:KANAMEE HOME HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCEO-YAP
Authorized Official - Suffix:
Authorized Official - Credentials:MSN RN BC
Authorized Official - Phone:661-965-1234
Mailing Address - Street 1:2049 PACIFIC COAST HWY STE 206
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-2662
Mailing Address - Country:US
Mailing Address - Phone:661-965-1234
Mailing Address - Fax:
Practice Address - Street 1:2049 PACIFIC COAST HWY STE 206
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-2662
Practice Address - Country:US
Practice Address - Phone:661-965-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health