Provider Demographics
NPI:1174877286
Name:KENNEDY HEALTH CARE, INC.
Entity type:Organization
Organization Name:KENNEDY HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L MOT
Authorized Official - Phone:561-714-7332
Mailing Address - Street 1:9273 OLMSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-3603
Mailing Address - Country:US
Mailing Address - Phone:561-714-7332
Mailing Address - Fax:561-964-7733
Practice Address - Street 1:9273 OLMSTEAD DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-3603
Practice Address - Country:US
Practice Address - Phone:561-714-7332
Practice Address - Fax:561-964-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-29
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10179253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care