Provider Demographics
NPI:1821752395
Name:KALAFUT, DAVID ANDREW
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANDREW
Last Name:KALAFUT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 N 10TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-6192
Mailing Address - Country:US
Mailing Address - Phone:888-527-0012
Mailing Address - Fax:
Practice Address - Street 1:28740 63RD ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:MI
Practice Address - Zip Code:49013-9314
Practice Address - Country:US
Practice Address - Phone:269-427-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities