Provider Demographics
NPI:1063399285
Name:KENMARK HOME CARE, LLC
Entity type:Organization
Organization Name:KENMARK HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GACHACHA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:574-217-7598
Mailing Address - Street 1:411 E MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-6210
Mailing Address - Country:US
Mailing Address - Phone:574-217-7598
Mailing Address - Fax:574-217-7752
Practice Address - Street 1:411 E MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-6210
Practice Address - Country:US
Practice Address - Phone:574-217-7598
Practice Address - Fax:574-217-7752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care