Provider Demographics
NPI:1023746591
Name:B&K HOMECARE LLC
Entity type:Organization
Organization Name:B&K HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KANGOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-226-9283
Mailing Address - Street 1:115 W BURLEIGH AVE APT 316
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-9046
Mailing Address - Country:US
Mailing Address - Phone:701-226-9283
Mailing Address - Fax:
Practice Address - Street 1:115 W BURLEIGH AVE APT 316
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-9046
Practice Address - Country:US
Practice Address - Phone:701-226-9283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care