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General NPI Number Information
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NPI Number | 1225115421
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Entity Type | Organization
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Legal Business Name | KCP HEALTH SERVICES, INC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 1306 NW JOHN JONES DR
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City | BURLESON
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State | TX
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Zip | 76028-8040
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Country | US
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Telephone | 817-297-3444
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Fax | 817-297-6822
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Provider Business Mailing Address
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Address Line | 1306 NW JOHN JONES DR
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City | BURLESON
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State | TX
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Zip | 76028-8040
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Country | US
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Telephone | 817-297-3444
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Fax | 817-297-6822
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CINDY VICKERS
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Credential | R.N.
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Telephone | 817-297-3444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 005680
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License Number State | TX
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