Provider Demographics
NPI:1871309328
Name:K&O COMMUNITY SERVICES
Entity type:Organization
Organization Name:K&O COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOHNNIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:531-203-3833
Mailing Address - Street 1:9910 N 48TH ST STE 111D
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-1548
Mailing Address - Country:US
Mailing Address - Phone:531-203-3833
Mailing Address - Fax:
Practice Address - Street 1:9910 N 48TH ST STE 111D
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-1548
Practice Address - Country:US
Practice Address - Phone:531-203-3833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care