Provider Demographics
NPI:1952128654
Name:KELLEY'S KARING TOUCH, LLC
Entity type:Organization
Organization Name:KELLEY'S KARING TOUCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MATILDA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, CLT
Authorized Official - Phone:409-659-7306
Mailing Address - Street 1:2750 HIGHWAY 12
Mailing Address - Street 2:
Mailing Address - City:VIDOR
Mailing Address - State:TX
Mailing Address - Zip Code:77662-3435
Mailing Address - Country:US
Mailing Address - Phone:409-659-7306
Mailing Address - Fax:409-422-0050
Practice Address - Street 1:2750 HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-3435
Practice Address - Country:US
Practice Address - Phone:409-659-7306
Practice Address - Fax:409-422-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center