Provider Demographics
NPI:1649354606
Name:K&K ASSISTED
Entity type:Organization
Organization Name:K&K ASSISTED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-931-3600
Mailing Address - Street 1:PO BOX 27560
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-0560
Mailing Address - Country:US
Mailing Address - Phone:313-931-3600
Mailing Address - Fax:313-933-3603
Practice Address - Street 1:12060 INDIANA ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48204-1084
Practice Address - Country:US
Practice Address - Phone:313-931-3600
Practice Address - Fax:313-933-3603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health