Provider Demographics
NPI:1487329249
Name:KAAUM ENTERPRISES
Entity type:Organization
Organization Name:KAAUM ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-396-3008
Mailing Address - Street 1:12728 WHEELER PEAK DR
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-8368
Mailing Address - Country:US
Mailing Address - Phone:719-396-3008
Mailing Address - Fax:
Practice Address - Street 1:155 PRINTERS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-6100
Practice Address - Country:US
Practice Address - Phone:719-396-3008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAAUM ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-13
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities