Provider Demographics
NPI:1124822143
Name:KDWEM HOME CARE LLC
Entity type:Organization
Organization Name:KDWEM HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DECKLAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-433-5610
Mailing Address - Street 1:13407 W 22ND PL
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2114
Mailing Address - Country:US
Mailing Address - Phone:806-433-5610
Mailing Address - Fax:
Practice Address - Street 1:6436 S RACINE CIR STE 102
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-6465
Practice Address - Country:US
Practice Address - Phone:806-433-5610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care