Provider Demographics
NPI:1699582569
Name:KI HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:KI HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAKILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-221-4169
Mailing Address - Street 1:1704 JUBILEE ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23523-2000
Mailing Address - Country:US
Mailing Address - Phone:833-221-4169
Mailing Address - Fax:
Practice Address - Street 1:1704 JUBILEE ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23523-2000
Practice Address - Country:US
Practice Address - Phone:833-221-4169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health