Provider Demographics
NPI:1992557631
Name:KIKIS HOME CARE
Entity type:Organization
Organization Name:KIKIS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPPERATION
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:CHANSA
Authorized Official - Last Name:KALOMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-400-3246
Mailing Address - Street 1:4209 W PAT ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57107-1839
Mailing Address - Country:US
Mailing Address - Phone:605-400-3246
Mailing Address - Fax:
Practice Address - Street 1:4209 W PAT ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57107-1839
Practice Address - Country:US
Practice Address - Phone:605-400-3246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIKIS HOMECARE SERIVCES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care