Provider Demographics
NPI:1184806051
Name:K-GROUP OF NC LLC
Entity type:Organization
Organization Name:K-GROUP OF NC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARLO
Authorized Official - Middle Name:J
Authorized Official - Last Name:KING
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-274-2082
Mailing Address - Street 1:PO BOX 15639
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28813-0639
Mailing Address - Country:US
Mailing Address - Phone:828-274-2082
Mailing Address - Fax:
Practice Address - Street 1:1550 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3187
Practice Address - Country:US
Practice Address - Phone:828-274-2082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2046251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7100422Medicaid