Provider Demographics
NPI:1669123766
Name:KMB ENDEAVORS, INC
Entity type:Organization
Organization Name:KMB ENDEAVORS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEELEE
Authorized Official - Middle Name:K
Authorized Official - Last Name:BURTCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-493-1483
Mailing Address - Street 1:5865 GRANITE WAY
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-7529
Mailing Address - Country:US
Mailing Address - Phone:303-493-1483
Mailing Address - Fax:
Practice Address - Street 1:5865 GRANITE WAY
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-7529
Practice Address - Country:US
Practice Address - Phone:303-493-1483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KMB ENDEAVORS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty