Provider Demographics
NPI:1417496720
Name:KD SERVICES
Entity Type:Organization
Organization Name:KD SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-806-4098
Mailing Address - Street 1:15509 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 3060
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3148
Mailing Address - Country:US
Mailing Address - Phone:203-806-4098
Mailing Address - Fax:
Practice Address - Street 1:15509 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 3060
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3148
Practice Address - Country:US
Practice Address - Phone:203-806-4098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7444282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAUNKNOWNMedicaid