Healthcare Provider Details

I. General information

NPI: 1528256336
Provider Name (Legal Business Name): KIDS FIRST ENTERPRIZE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 08/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4467 INDEPENDENCE DR
PLEASANT HILL IA
50327-1734
US

IV. Provider business mailing address

4467 INDEPENDENCE DR
PLEASANT HILL IA
50327-1734
US

V. Phone/Fax

Practice location:
  • Phone: 515-334-5025
  • Fax:
Mailing address:
  • Phone: 515-334-5025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. BRADLEY KENT KEIL
Title or Position: PRESIDENT/CEO
Credential: MSHS
Phone: 515-334-5025