Provider Demographics
NPI:1568695013
Name:KREW ENTERPRISES, INC BDA COMFORT KEEPERS, 490
Entity Type:Organization
Organization Name:KREW ENTERPRISES, INC BDA COMFORT KEEPERS, 490
Other - Org Name:COMFORT KEEPERS (D/B/A)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEZLIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SNOOZY-KAITFORS
Authorized Official - Suffix:
Authorized Official - Credentials:GCMC
Authorized Official - Phone:605-717-4444
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783
Mailing Address - Country:US
Mailing Address - Phone:605-717-4444
Mailing Address - Fax:605-717-4445
Practice Address - Street 1:119 EAST GRANT STREET, STE 1
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783
Practice Address - Country:US
Practice Address - Phone:605-717-4444
Practice Address - Fax:605-717-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health