Healthcare Provider Details

I. General information

NPI: 1801257530
Provider Name (Legal Business Name): KMB ENDEAVORS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14415 E SMOKY HILL RD
AURORA CO
80015-1238
US

IV. Provider business mailing address

14415 E SMOKY HILL RD
AURORA CO
80015-1238
US

V. Phone/Fax

Practice location:
  • Phone: 720-524-7648
  • Fax: 720-542-9098
Mailing address:
  • Phone: 720-524-7648
  • Fax: 720-542-9098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number11417336
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DR. KEELEE KATHLEEN BURTCH
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD BCBA
Phone: 303-493-1483