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General NPI Number Information
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NPI Number | 1306571443
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Entity Type | Organization
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Legal Business Name | KFCM VENTURES, LLC
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Dates
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Enumeration Date | 07/21/2022
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4775 S DURANGO DR STE 104
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City | LAS VEGAS
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State | NV
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Zip | 89147-8157
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Country | US
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Telephone | 702-691-4380
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Fax | 702-691-4381
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Provider Business Mailing Address
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Address Line | 4775 S DURANGO DR STE 104
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City | LAS VEGAS
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State | NV
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Zip | 89147-8157
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Country | US
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Telephone | 702-691-4380
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Fax | 702-691-4381
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. KEVIN OCAMPO
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Credential |
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Telephone | 702-691-4380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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