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KD SUPPORT SERVICES NPI 1881054658


NPI Information

NPI: 1881054658
Provider Name: KD SUPPORT SERVICES

Doing Business As: KELLYS CARE

Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
2073 HARRIS HENRIETTA RD
MOORESBORO, NC
ZIP 28114
Phone: (828) 657-4757
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KD SUPPORT SERVICES is a residential treatment facility, intellectual and/or developmental disabilities in Mooresboro, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. KD SUPPORT SERVICES NPI is 1881054658. The provider is registered as an organization entity type.
The provider Is Doing Business As Kellys Care.

The provider's business location address is:

2073 HARRIS HENRIETTA RD
MOORESBORO, NC
ZIP 28114-233
Phone: (828) 657-4757
Fax: (828) 245-4099

The provider's authorized official is Kenneth Dellinger .
The authorized official title is Director Of Operations and has the following contact phone number (828) 245-4011.

The enumeration date for this NPI number is 3/7/2016 and was last updated on 3/7/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL-081-069NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13418462MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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