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General NPI Number Information
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NPI Number | 1154653061
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Entity Type | Organization
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Legal Business Name | KCLC, LLC
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 7300 BLANCO RD SUITE 103
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City | SAN ANTONIO
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State | TX
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Zip | 78216-4936
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Country | US
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Telephone | 210-508-4576
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Fax |
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Provider Business Mailing Address
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Address Line | 7300 BLANCO RD SUITE 103
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City | SAN ANTONIO
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State | TX
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Zip | 78216-4936
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Country | US
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Telephone | 210-508-4576
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KAREN LEE KEACH
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Credential |
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Telephone | 210-508-4576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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