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General NPI Number Information
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NPI Number | 1760236699
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Entity Type | Organization
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Legal Business Name | K.A.R.M.A KINDRED ASCENSION, REVITALIZATION MOTIVATIONAL ALTRUISM INC
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Dates
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Enumeration Date | 04/16/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 930 S 4TH ST STE 209
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City | LAS VEGAS
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State | NV
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Zip | 89101-6845
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Country | US
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Telephone | 725-306-9518
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 S DURANGO DR APT 1061
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City | LAS VEGAS
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State | NV
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Zip | 89117-2639
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VALYRICA RAYKELLE LEWIS
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Credential |
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Telephone | 213-778-2336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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