Provider Demographics
NPI:1518377357
Name:KB HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:KB HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:INTRES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-774-3865
Mailing Address - Street 1:275 S CHEROKEE ST APT 3306
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-2093
Mailing Address - Country:US
Mailing Address - Phone:303-539-9362
Mailing Address - Fax:773-382-8622
Practice Address - Street 1:2433 W 44TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-1507
Practice Address - Country:US
Practice Address - Phone:303-539-9362
Practice Address - Fax:773-382-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007089261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center