Provider Demographics
NPI:1083089056
Name:K&J LOVING HANDS
Entity Type:Organization
Organization Name:K&J LOVING HANDS
Other - Org Name:K&J LOVING HANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KENYETTA
Authorized Official - Middle Name:ELISA
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-513-5332
Mailing Address - Street 1:3333 VAN CAMPEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3346
Mailing Address - Country:US
Mailing Address - Phone:810-513-5332
Mailing Address - Fax:
Practice Address - Street 1:3333 VAN CAMPEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3346
Practice Address - Country:US
Practice Address - Phone:810-513-5332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care