Provider Demographics
NPI:1255046637
Name:4K HOME CARE, INC
Entity type:Organization
Organization Name:4K HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAKISHA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:MCNEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-658-4911
Mailing Address - Street 1:PO BOX 2064
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28335-2064
Mailing Address - Country:US
Mailing Address - Phone:910-658-4911
Mailing Address - Fax:
Practice Address - Street 1:804 S GARNETT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4571
Practice Address - Country:US
Practice Address - Phone:910-658-4911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care