Provider Demographics
NPI:1740458561
Name:KITE, JANICE ELAINE
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:ELAINE
Last Name:KITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2549 E ALFALFA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-8169
Mailing Address - Country:US
Mailing Address - Phone:573-474-6919
Mailing Address - Fax:157-347-4691
Practice Address - Street 1:2549 E ALFALFA DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-8169
Practice Address - Country:US
Practice Address - Phone:573-474-6919
Practice Address - Fax:573-474-6919
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities