Provider Demographics
NPI:1124821004
Name:KJT SUPPORT SOLUTIONS
Entity type:Organization
Organization Name:KJT SUPPORT SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NNENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NZELIBE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:443-622-5262
Mailing Address - Street 1:2532 ASHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1755
Mailing Address - Country:US
Mailing Address - Phone:443-622-5262
Mailing Address - Fax:
Practice Address - Street 1:2532 ASHBROOK DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-1755
Practice Address - Country:US
Practice Address - Phone:443-622-5262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty