Provider Demographics
NPI:1215372990
Name:KBS
Entity Type:Organization
Organization Name:KBS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BIJOU
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-421-5789
Mailing Address - Street 1:101 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-5253
Mailing Address - Country:US
Mailing Address - Phone:248-687-1829
Mailing Address - Fax:248-687-1001
Practice Address - Street 1:101 W BIG BEAVER RD
Practice Address - Street 2:SUITE 1400
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-5253
Practice Address - Country:US
Practice Address - Phone:248-687-1829
Practice Address - Fax:248-687-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health