Healthcare Provider Details

I. General information

NPI: 1164381000
Provider Name (Legal Business Name): KDD GROUP BILLING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9802 W VAN BUREN ST UNIT 227
TOLLESON AZ
85353-2855
US

IV. Provider business mailing address

9802 W VAN BUREN ST UNIT 227
TOLLESON AZ
85353-2855
US

V. Phone/Fax

Practice location:
  • Phone: 714-905-2340
  • Fax:
Mailing address:
  • Phone: 714-905-2340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: GRACE KEISHANYU
Title or Position: CEO
Credential:
Phone: 714-905-2340