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General NPI Number Information
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NPI Number | 1952965667
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Entity Type | Organization
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Legal Business Name | K & J CARE ENTERPRISES, INC.
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Dates
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Enumeration Date | 04/28/2019
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Last Update Date | 04/28/2019
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Provider Practice Location Address
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Address Line | 614 S MAIN ST
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City | CLINTON
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State | MO
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Zip | 64735-2620
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Country | US
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Telephone | 660-885-7412
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Fax | 866-567-0791
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Provider Business Mailing Address
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Address Line | PO BOX 9655
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City | SPRINGFIELD
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State | MO
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Zip | 65801-9655
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Country | US
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Telephone | 417-773-1892
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Fax | 866-567-0791
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Authorized Official
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Title or Position | OWNER
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Name | KATHY S MCCRARY
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Credential |
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Telephone | 417-773-1892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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