Provider Demographics
NPI:1265274005
Name:KDL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:KDL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DONTAE
Authorized Official - Last Name:DYSON-LOMAX
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CCM, BSN, MBA
Authorized Official - Phone:443-322-6488
Mailing Address - Street 1:1250 S BUCKLEY RD UNIT I-247
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4180
Mailing Address - Country:US
Mailing Address - Phone:303-736-8138
Mailing Address - Fax:303-736-8283
Practice Address - Street 1:445 S AIRPORT BLVD STE I
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-2123
Practice Address - Country:US
Practice Address - Phone:443-322-6488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health