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General NPI Number Information
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NPI Number | 1326718107
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Entity Type | Organization
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Legal Business Name | KA' EXCLUSIVE INITIATIVES, INC
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 930 NORTH ST
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City | LIVINGSTON
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State | AL
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Zip | 35470-5312
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Country | US
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Telephone | 205-383-9594
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Fax |
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Provider Business Mailing Address
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Address Line | 930 NORTH ST
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City | LIVINGSTON
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State | AL
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Zip | 35470-5312
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Country | US
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Telephone | 205-383-9594
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | KATHERIA EDWARDS
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Credential |
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Telephone | 205-383-9594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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