Provider Demographics
NPI:1114772043
Name:KAREPRIDE LLC
Entity type:Organization
Organization Name:KAREPRIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABONGWA
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:405-408-8574
Mailing Address - Street 1:487 59TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-8025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:487 59TH AVE S
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-8025
Practice Address - Country:US
Practice Address - Phone:405-408-8574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health