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General NPI Number Information
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NPI Number | 1316753403
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Entity Type | Organization
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Legal Business Name | K&K LEGACY LLC
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 1330 TARA PIPER LN
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City | BLACKLICK
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State | OH
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Zip | 43004-7539
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Country | US
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Telephone | 614-589-5651
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 TARA PIPER LN
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City | BLACKLICK
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State | OH
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Zip | 43004-7539
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Country | US
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Telephone | 614-589-5651
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Fax |
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Authorized Official
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Title or Position | OWNER AND CEO
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Name | FOULEMATOU KABA
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Credential |
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Telephone | 614-589-5651
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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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