Provider Demographics
NPI:1154588754
Name:CKC ENTERPRISES INC
Entity type:Organization
Organization Name:CKC ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:K
Authorized Official - Last Name:COMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-296-8080
Mailing Address - Street 1:625 E 70TH AVE
Mailing Address - Street 2:UNIT 1-W
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80229
Mailing Address - Country:US
Mailing Address - Phone:303-296-8080
Mailing Address - Fax:303-338-8191
Practice Address - Street 1:625 E 70TH AVE
Practice Address - Street 2:UNIT 1-W
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80229
Practice Address - Country:US
Practice Address - Phone:303-296-8080
Practice Address - Fax:303-338-8191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CKC ENTERPRISES INC DBA PAUL DAVIS RESTORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23173171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO95320032Medicaid