Provider Demographics
NPI:1023419199
Name:KIMMY;S NEST HOME CARE L.L.C
Entity type:Organization
Organization Name:KIMMY;S NEST HOME CARE L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:SIMONA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-772-3361
Mailing Address - Street 1:16158 DEXTER AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-3002
Mailing Address - Country:US
Mailing Address - Phone:313-772-3361
Mailing Address - Fax:313-864-4109
Practice Address - Street 1:16158 DEXTER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-3002
Practice Address - Country:US
Practice Address - Phone:313-772-3361
Practice Address - Fax:313-864-4109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care