Provider Demographics
NPI:1164803995
Name:KKS CORPORATION
Entity Type:Organization
Organization Name:KKS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:V
Authorized Official - Last Name:YELENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1917-364-5814
Mailing Address - Street 1:6 LANDMARK SQ FL 4
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-2704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 LANDMARK SQ FL 4
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-2704
Practice Address - Country:US
Practice Address - Phone:203-690-7728
Practice Address - Fax:203-359-5858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0001008253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care