Organization
KICK DOOR KOLLEKTIVE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DINITA M. WHITE (OWNER)
(760) 680-5471
Entity
Organization
Contact information
Practice address
27313 WILLOW LEAF RD, MORENO VALLEY, CA 92555-4755
(760) 680-5471
Mailing address
27313 WILLOW LEAF RD, MORENO VALLEY, CA 92555-4755
(760) 680-5471
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/09/2025
Last updated
05/09/2025
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