Provider Demographics
NPI:1881878254
Name:KUKU NEST
Entity type:Organization
Organization Name:KUKU NEST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:ABLA
Authorized Official - Last Name:AWADJIE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MAOM
Authorized Official - Phone:817-797-2887
Mailing Address - Street 1:316 CHASE HILL LN
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7082
Mailing Address - Country:US
Mailing Address - Phone:817-797-2887
Mailing Address - Fax:
Practice Address - Street 1:316 CHASE HILL LN
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7082
Practice Address - Country:US
Practice Address - Phone:817-797-2887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility