# KITE GROUP LLC

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

## Provider details

- **NPI number:** 1689259269
- **Authorized official:** AYLIE GRAY CREDENTIALING (MANAGER)
- **Authorized official phone:** (337) 581-5112

## Contact information

- **Practice address:** 913 ALFRED ST, SCOTT, LA 70583-5117
- **Practice address phone:** (337) 504-3697
- **Practice address fax:** (337) 504-2871
- **Mailing address:** 203 LUCE DR, LAFAYETTE, LA 70506-2862
- **Mailing address phone:** (337) 781-0384

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2021
- **Last updated:** 03/15/2021