Organization
KLLG CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAMARA GEE (OWNER/PRESIDENT)
(707) 268-8699
Entity
Organization
Contact information
Practice address
3231 DOLBEER ST, EUREKA, CA 95503-5631
(707) 444-2076
(707) 444-2079
Mailing address
PO BOX 408, CUTTEN, CA 95534-0408
(707) 268-8699
(707) 442-9274
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
126803419
CA
310400000X
Assisted Living Facility
126803492
CA
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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