Provider Demographics
NPI:1154343291
Name:KASS INC
Entity type:Organization
Organization Name:KASS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SYSTEM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:STRAWTHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-451-6413
Mailing Address - Street 1:2817 STARK ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-6562
Mailing Address - Country:US
Mailing Address - Phone:817-451-6413
Mailing Address - Fax:817-457-1673
Practice Address - Street 1:2817 STARK ST
Practice Address - Street 2:SUITE D
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-6562
Practice Address - Country:US
Practice Address - Phone:817-451-6413
Practice Address - Fax:817-451-1673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX454812Medicare ID - Type UnspecifiedPROVIDER NUMBER