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Organization
KKC LIFE MANAGEMENT SERVICES
Active
Organization
KKC LIFE MANAGEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA ATKINS HOLSHUE QMHS (QMHS)
(234) 736-8425
Entity
Organization
Contact information
Practice address
136 S MARKET ST, LISBON, OH 44432-1232
(234) 736-8425
(330) 954-0880
Mailing address
136 S MARKET ST, LISBON, OH 44432-1232
(234) 736-8425
(330) 954-0880
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0381705
—
OH
Enumeration date
01/25/2021
Last updated
01/25/2021
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