Provider Demographics
NPI:1164069266
Name:K K ENTERPRISE
Entity Type:Organization
Organization Name:K K ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KNUTSSON
Authorized Official - Suffix:
Authorized Official - Credentials:ALC, NCC, MED
Authorized Official - Phone:205-936-0489
Mailing Address - Street 1:2328 ALTADENA CREST DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4400
Mailing Address - Country:US
Mailing Address - Phone:205-936-0489
Mailing Address - Fax:
Practice Address - Street 1:100 CENTURY PARK S STE 102
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35226-3922
Practice Address - Country:US
Practice Address - Phone:888-386-9624
Practice Address - Fax:205-383-3253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-08
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty