Provider Demographics
NPI:1518253764
Name:KLEAN KING BUILDING MAINTENANCE
Entity Type:Organization
Organization Name:KLEAN KING BUILDING MAINTENANCE
Other - Org Name:MICHELLE WATSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CORDELL
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-704-5866
Mailing Address - Street 1:PO BOX 851137
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75185-1137
Mailing Address - Country:US
Mailing Address - Phone:972-704-5866
Mailing Address - Fax:
Practice Address - Street 1:2136 TRADEWIND DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3361
Practice Address - Country:US
Practice Address - Phone:972-704-5866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility