Provider Demographics
NPI:1689057739
Name:KAZAK GROUP LLC
Entity Type:Organization
Organization Name:KAZAK GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-930-9572
Mailing Address - Street 1:4688 QUARTON RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2541
Mailing Address - Country:US
Mailing Address - Phone:248-930-9572
Mailing Address - Fax:
Practice Address - Street 1:4688 QUARTON RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-2541
Practice Address - Country:US
Practice Address - Phone:248-930-9572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home