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General NPI Number Information
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NPI Number | 1568747384
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Entity Type | Organization
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Legal Business Name | K AND M HEALTHCARE
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 110 TIMSON DR
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City | FOLSOM
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State | CA
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Zip | 95630-5531
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Country | US
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Telephone | 707-732-0181
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Fax |
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Provider Business Mailing Address
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Address Line | 110 TIMSON DR
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City | FOLSOM
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State | CA
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Zip | 95630-5531
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Country | US
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Telephone | 707-732-0181
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. KEITH ROBERT HALLUMS
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Credential |
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Telephone | 707-732-0181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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