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General NPI Number Information
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NPI Number | 1841474178
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Entity Type | Organization
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Legal Business Name | KELS, LLC
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 2 COURTYARD LN
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-1015
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Country | US
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Telephone | 304-736-3005
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Fax | 304-736-2888
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Provider Business Mailing Address
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Address Line | 4 JAMES DR
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City | HUNTINGTON
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State | WV
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Zip | 25705-2353
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Country | US
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Telephone | 304-736-9424
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MS. KELLY WINIFRED SHIVEL
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Credential |
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Telephone | 304-736-3005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 008751
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 008751
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License Number State | WV
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