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General NPI Number Information
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NPI Number | 1114069010
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Entity Type | Organization
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Legal Business Name | KD&S HOMES INC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 1223 BALTIMORE ST
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City | DURANT
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State | OK
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Zip | 74701-3243
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Country | US
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Telephone | 580-924-0496
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Fax | 580-924-7724
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Provider Business Mailing Address
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Address Line | 1223 BALTIMORE ST
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City | DURANT
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State | OK
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Zip | 74701-3243
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Country | US
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Telephone | 580-924-0496
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Fax | 580-924-7724
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHRISTIE BARTLEY
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Credential |
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Telephone | 580-924-0496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | NH0705-0705
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License Number State | OK
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