Healthcare Provider Details

I. General information

NPI: 1407778277
Provider Name (Legal Business Name): KISS MY GRITS KITCHEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18221 NW 40TH CT
MIAMI GARDENS FL
33055-3437
US

IV. Provider business mailing address

18221 NW 40TH CT
MIAMI GARDENS FL
33055-3437
US

V. Phone/Fax

Practice location:
  • Phone: 305-764-4005
  • Fax:
Mailing address:
  • Phone: 305-764-4005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State

VIII. Authorized Official

Name: ALICE SANDERS
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 305-764-4005