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General NPI Number Information
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NPI Number | 1609254911
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Entity Type | Organization
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Legal Business Name | KLW & FRIENDS, LLC
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 3804 JOHN STOCKBAUER DR SUITE E
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City | VICTORIA
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State | TX
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Zip | 77904-2448
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Country | US
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Telephone | 361-575-4500
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Fax | 361-575-4502
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Provider Business Mailing Address
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Address Line | PO BOX 4802
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City | VICTORIA
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State | TX
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Zip | 77903-4802
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Country | US
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Telephone | 361-575-4500
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Fax | 361-575-4502
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Authorized Official
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Title or Position | OWNER
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Name | KELLY L WEBB
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Credential |
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Telephone | 361-575-4500
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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 | 010140
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License Number State | TX
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