# K AND K ASSISTED LIVING \#1 LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255165817
- **Authorized official:** MR. CARLOS R BROWN (ACCOUNTANT)
- **Authorized official phone:** (313) 915-7158

## Contact information

- **Practice address:** 12054 INDIANA, DETROIT, MI 48204
- **Practice address phone:** (313) 231-3604
- **Mailing address:** 12054 INDIANA, DETROIT, MI 48204
- **Mailing address phone:** (313) 231-3604

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 08/27/2024
- **Last updated:** 08/27/2024