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NPI Code Detail

MEDICARE: K.A.R.M.A KINDRED ASCENSION, REVITALIZATION MOTIVATIONAL ALTRUISM INC

MEDICARE: K.A.R.M.A KINDRED ASCENSION, REVITALIZATION MOTIVATIONAL ALTRUISM INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1760236699
Entity Type Code : Organization
Provider Name (Legal Business Name) : K.A.R.M.A KINDRED ASCENSION, REVITALIZATION MOTIVATIONAL ALTRUISM INC
Provider Business Mailing Address
First Line : 2750 S DURANGO DR APT 1061
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-2639
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 930 S 4TH ST STE 209
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-6845
Country : US
Telephone Number : 725-306-9518
Fax Number :
Authorized Official
Title or Position : CEO
Name : VALYRICA RAYKELLE LEWIS
Credential :
Telephone Number : 213-778-2336
Provider Enumeration Date : 04/16/2024
Last Update Date : 04/22/2024

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