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General NPI Number Information
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NPI Number | 1902417090
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Entity Type | Organization
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Legal Business Name | KAVERE SERVICES INC
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Dates
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Enumeration Date | 08/12/2020
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 531 N MILLS AVE
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City | LODI
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State | CA
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Zip | 95242-2220
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Country | US
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Telephone | 209-992-3318
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Fax |
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Provider Business Mailing Address
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Address Line | 531 N MILLS AVE
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City | LODI
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State | CA
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Zip | 95242-2220
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Country | US
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Telephone | 209-992-3318
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. RICHARD A HERRERA
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Credential | M.S.ED.
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Telephone | 209-992-3318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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License Number State |
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