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General NPI Number Information
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NPI Number | 1730135161
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Entity Type | Organization
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Legal Business Name | K & K LIVING CENTER, INC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 16802 JUDYLEIGH DR
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City | HOUSTON
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State | TX
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Zip | 77084-1949
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Country | US
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Telephone | 281-859-9474
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Fax | 281-859-8037
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Provider Business Mailing Address
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Address Line | PO BOX 842679
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City | HOUSTON
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State | TX
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Zip | 77284-2679
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Country | US
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Telephone | 281-859-9474
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Fax | 281-859-8037
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DONNIE H MCGRAW
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Credential |
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Telephone | 281-859-9474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 0000H08KC
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 000738701/ 000759701
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License Number State | TX
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