Provider Demographics
NPI:1578841805
Name:KDOVE FOUNDATION
Entity Type:Organization
Organization Name:KDOVE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-217-6815
Mailing Address - Street 1:13414 ENSLEY WOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5020
Mailing Address - Country:US
Mailing Address - Phone:832-217-6815
Mailing Address - Fax:832-204-4514
Practice Address - Street 1:13414 ENSLEY WOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5020
Practice Address - Country:US
Practice Address - Phone:832-217-6815
Practice Address - Fax:832-204-4514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health