Provider Demographics
NPI:1578256442
Name:KLY ENTERPRISE LLC
Entity Type:Organization
Organization Name:KLY ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KEIONDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-315-9730
Mailing Address - Street 1:5533 SOUTHWYCK BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1505
Mailing Address - Country:US
Mailing Address - Phone:419-409-8428
Mailing Address - Fax:419-409-8429
Practice Address - Street 1:5533 SOUTHWYCK BLVD STE 101
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1505
Practice Address - Country:US
Practice Address - Phone:419-409-8428
Practice Address - Fax:419-409-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-29
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle