Provider Demographics
NPI:1063258085
Name:KSK HOME CARE INC
Entity type:Organization
Organization Name:KSK HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHUDAVERDYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-660-0070
Mailing Address - Street 1:1941 CALLE SIRENA
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-3034
Mailing Address - Country:US
Mailing Address - Phone:818-660-0070
Mailing Address - Fax:
Practice Address - Street 1:1941 CALLE SIRENA
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-3034
Practice Address - Country:US
Practice Address - Phone:818-660-0070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health