Provider Demographics
NPI:1285869297
Name:KDM'S SERVICES,INC
Entity type:Organization
Organization Name:KDM'S SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-726-6722
Mailing Address - Street 1:6412 N UNIVERSITY DR
Mailing Address - Street 2:#114
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-4055
Mailing Address - Country:US
Mailing Address - Phone:954-726-6722
Mailing Address - Fax:954-726-6723
Practice Address - Street 1:6412 N UNIVERSITY DR
Practice Address - Street 2:#114
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-4055
Practice Address - Country:US
Practice Address - Phone:954-726-6722
Practice Address - Fax:954-726-6723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL688089496Medicaid
FL688089498Medicaid