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General NPI Number Information
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NPI Number | 1568695013
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Entity Type | Organization
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Legal Business Name | KREW ENTERPRISES, INC BDA COMFORT KEEPERS, 490
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 119 EAST GRANT STREET, STE 1
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City | SPEARFISH
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State | SD
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Zip | 57783
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Country | US
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Telephone | 605-717-4444
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Fax | 605-717-4445
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Provider Business Mailing Address
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Address Line | PO BOX 1267
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City | SPEARFISH
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State | SD
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Zip | 57783
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Country | US
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Telephone | 605-717-4444
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Fax | 605-717-4445
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LEZLIE ANNE SNOOZY-KAITFORS
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Credential | GCMC
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Telephone | 605-717-4444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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