Provider Demographics
NPI:1285107011
Name:KAYLEE'S IN HOME CARE SERVICES
Entity type:Organization
Organization Name:KAYLEE'S IN HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-630-4536
Mailing Address - Street 1:124 TUSCANY CT
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-4089
Mailing Address - Country:US
Mailing Address - Phone:678-630-4536
Mailing Address - Fax:
Practice Address - Street 1:124 TUSCANY CT
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-4089
Practice Address - Country:US
Practice Address - Phone:678-630-4536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA075-R-1813OtherHEALTHCARE FACILITY REGULATION