Provider Demographics
NPI:1518574292
Name:K ANB B SERVICES, LLC
Entity Type:Organization
Organization Name:K ANB B SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:623-337-2264
Mailing Address - Street 1:51 E MONROE AVE UNIT 1122
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-7544
Mailing Address - Country:US
Mailing Address - Phone:623-337-2264
Mailing Address - Fax:
Practice Address - Street 1:23837 W WAYLAND DR
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-7020
Practice Address - Country:US
Practice Address - Phone:623-337-2264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ09202014291OtherDDD ARIZONA