Provider Demographics
NPI:1043352859
Name:KAMBS,LLC
Entity Type:Organization
Organization Name:KAMBS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:VYE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:231-933-4339
Mailing Address - Street 1:3016 LAFRANIER RD
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-4919
Mailing Address - Country:US
Mailing Address - Phone:231-933-4339
Mailing Address - Fax:231-933-4339
Practice Address - Street 1:3020 LAFRANIER RD
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-4919
Practice Address - Country:US
Practice Address - Phone:231-933-4339
Practice Address - Fax:231-933-4339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAL280071660310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility