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General NPI Number Information
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NPI Number | 1366250102
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Entity Type | Organization
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Legal Business Name | KP ENTERPRISES, INC
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 72 GREENE ST
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City | CUMBERLAND
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State | MD
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Zip | 21502-2933
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Country | US
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Telephone | 301-682-2041
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Fax |
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Provider Business Mailing Address
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Address Line | 8435 PROGRESS DR STE FF
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City | FREDERICK
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State | MD
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Zip | 21701-4981
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE ADMINISTRATOR
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Name | GLORIA CORBIN
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Credential |
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Telephone | 301-732-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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