Healthcare Provider Details

I. General information

NPI: 1164213146
Provider Name (Legal Business Name): KHLOE'S KOVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18214 ALEMARBLE OAK ST
CYPRESS TX
77429-1414
US

IV. Provider business mailing address

18214 ALEMARBLE OAK ST
CYPRESS TX
77429-1414
US

V. Phone/Fax

Practice location:
  • Phone: 737-262-1666
  • Fax:
Mailing address:
  • Phone: 737-262-1666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOB BALLARD
Title or Position: CEO
Credential:
Phone: 737-262-1666