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NPI Code Detail

MEDICARE: KKS SERVICES, LLC

MEDICARE: KKS SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency010019TX
2251E00000XHome Health Agency016859TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033276936
Entity Type Code : Organization
Provider Name (Legal Business Name) : KKS SERVICES, LLC
Provider Business Mailing Address
First Line : 513 S 1ST ST
Second Line :
City : LUFKIN
State : TX
Zip : 75901-3867
Country : US
Telephone Number : 936-634-1166
Fax Number : 936-634-1571
Provider Business Practice Location Address
First Line : 513 S 1ST ST
Second Line :
City : LUFKIN
State : TX
Zip : 75901-3867
Country : US
Telephone Number : 936-634-1166
Fax Number : 936-634-1571
Authorized Official
Title or Position : OWNER/ADMINISTRATOR
Name : KATHLYN RENE JACKSON
Credential : RN, MSN
Telephone Number : 936-634-1166
Provider Enumeration Date : 01/02/2007
Last Update Date : 07/23/2015

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Directions to “KKS SERVICES, LLC ” Practice Location

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