Provider Demographics
NPI:1962711457
Name:KDR SERVICES INC.
Entity type:Organization
Organization Name:KDR SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-884-3930
Mailing Address - Street 1:1127 PRAIRIE DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-5662
Mailing Address - Country:US
Mailing Address - Phone:262-884-3930
Mailing Address - Fax:262-884-3932
Practice Address - Street 1:1127 PRAIRIE DR
Practice Address - Street 2:SUITE 600
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-5662
Practice Address - Country:US
Practice Address - Phone:262-884-3930
Practice Address - Fax:262-884-3932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care