Provider Demographics
NPI:1407448905
Name:KYJO ENTERPRISES, INC.
Entity Type:Organization
Organization Name:KYJO ENTERPRISES, INC.
Other - Org Name:BARSTOW HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:DANTE
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-243-7002
Mailing Address - Street 1:114 E SHAW AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3138 W BARSTOW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-2603
Practice Address - Country:US
Practice Address - Phone:559-243-7002
Practice Address - Fax:559-243-5740
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KYJO ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-05
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness