Provider Demographics
NPI:1366845901
Name:KALEO SUPPORTS, INC.
Entity Type:Organization
Organization Name:KALEO SUPPORTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SZYMKOWIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-630-2255
Mailing Address - Street 1:3718 GOLFVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2818
Mailing Address - Country:US
Mailing Address - Phone:910-322-2755
Mailing Address - Fax:910-339-2808
Practice Address - Street 1:7336 SHILLINGLAW CIR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-6254
Practice Address - Country:US
Practice Address - Phone:910-630-2255
Practice Address - Fax:910-339-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-26
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418487Medicaid