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General NPI Number Information
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NPI Number | 1265869572
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Entity Type | Organization
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Legal Business Name | KB PERSONAL CARE SERVICES, LLC
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Dates
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Enumeration Date | 10/01/2013
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 109 LOS MIRADORES DR NE
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City | RIO RANCHO
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State | NM
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Zip | 87124-4279
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Country | US
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Telephone | 505-275-0812
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Fax | 505-332-7512
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Provider Business Mailing Address
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Address Line | 109 LOS MIRADORES DR NE
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City | RIO RANCHO
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State | NM
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Zip | 87124-4279
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Country | US
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Telephone | 505-275-0812
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Fax | 505-332-7512
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MRS. KIMBERLY A BUCKMAN
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Credential |
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Telephone | 505-275-0812
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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 |
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License Number State |
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