Provider Demographics
NPI:1083978779
Name:KC-KIDS STARS
Entity Type:Organization
Organization Name:KC-KIDS STARS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPRIELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-305-7130
Mailing Address - Street 1:1220 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-3595
Mailing Address - Country:US
Mailing Address - Phone:559-305-7130
Mailing Address - Fax:559-638-0026
Practice Address - Street 1:1220 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-3595
Practice Address - Country:US
Practice Address - Phone:559-305-7130
Practice Address - Fax:559-638-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health