Organization · NPI-2

Kind Hearts Care Services LLC

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Peoria, AZ

NPI number1447934005

StatusActive

Last updated in NPPESJun 14, 2023

Details

NPI: 1447934005
Entity type: Organization (NPI-2)
Legal business name: Kind Hearts Care Services LLC
Organization subpart: No
Enumeration date: Jun 14, 2023
Certification date: Jun 13, 2023
Last updated: Jun 14, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–	Yes
343900000X	Non-emergency Medical Transport (VAN)	–	–
385H00000X	Respite Care	–	–
251C00000X	Day Training, Developmentally Disabled Services	–	–
251S00000X	Community/Behavioral Health	–	–
253Z00000X	In Home Supportive Care	–	–
315P00000X	Intermediate Care Facility, Intellectual Disabilities	–	–
320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–

Practice location

7672 W Betty Elyse Ln
Peoria, AZ 85382-3835

Phone 480-430-8622

Mailing address

7672 W Betty Elyse Ln
Peoria, AZ 85382-3835

Phone 480-430-8622

Authorized official

Kenneth Katongole
C.E.O
4804308622

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