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General NPI Number Information
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NPI Number | 1982279923
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Entity Type | Organization
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Legal Business Name | KJ ELITE VENTURES INC
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 1635 FOXTRAIL DR
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City | LOVELAND
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State | CO
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Zip | 80538-9086
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Country | US
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Telephone | 970-776-4376
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Fax |
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Provider Business Mailing Address
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Address Line | 1635 FOXTRAIL DR
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City | LOVELAND
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State | CO
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Zip | 80538-9086
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Country | US
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Telephone | 970-776-4376
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATELYN JEAN RICKE
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Credential |
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Telephone | 970-980-5402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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