Provider Demographics
NPI:1104557008
Name:K&I PROVIDER SERVICES INC.
Entity type:Organization
Organization Name:K&I PROVIDER SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAVITT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-308-5499
Mailing Address - Street 1:8919 ASPEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-3256
Mailing Address - Country:US
Mailing Address - Phone:832-308-5499
Mailing Address - Fax:832-968-6692
Practice Address - Street 1:8919 ASPEN MEADOW DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-3256
Practice Address - Country:US
Practice Address - Phone:832-308-5499
Practice Address - Fax:832-968-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX022665OtherLICENSE