Provider Demographics
NPI:1417081100
Name:K & L CORF LLC
Entity Type:Organization
Organization Name:K & L CORF LLC
Other - Org Name:KALAMAZOO REHABILATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DONN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LATOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-327-7075
Mailing Address - Street 1:PO BOX 2565
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49081-2565
Mailing Address - Country:US
Mailing Address - Phone:269-373-8878
Mailing Address - Fax:267-373-4720
Practice Address - Street 1:2340 E CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-4465
Practice Address - Country:US
Practice Address - Phone:269-327-7075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5256490001Medicare NSC