Provider Demographics
NPI:1225418346
Name:KING'S WAY HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:KING'S WAY HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:D
Authorized Official - Last Name:WUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-439-2536
Mailing Address - Street 1:1261 BYRNWYCK CT
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-8843
Mailing Address - Country:US
Mailing Address - Phone:419-439-2536
Mailing Address - Fax:
Practice Address - Street 1:1261 BYRNWYCK CT
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-8843
Practice Address - Country:US
Practice Address - Phone:419-439-2536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health