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General NPI Number Information
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NPI Number | 1417663683
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Entity Type | Organization
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Legal Business Name | KET CARES & EDUCATION LLC
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 3411 LINECREST RD
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City | ELLENWOOD
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State | GA
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Zip | 30294-1843
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Country | US
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Telephone | 305-804-2959
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Fax |
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Provider Business Mailing Address
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Address Line | 101 FAIRVIEW RD # 125
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City | ELLENWOOD
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State | GA
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Zip | 30294-2722
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Country | US
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Telephone | 305-804-2959
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KETIA ALEXANDRE
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Credential | RN, MSN
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Telephone | 305-804-2959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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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 | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development 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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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