Organization
KDDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA D BROUGHTON (OWNER)
(615) 481-1685
Entity
Organization
Contact information
Practice address
410 RIDGETOP DR, SMYRNA, TN 37167-5109
(615) 481-1685
(615) 223-7190
Mailing address
PO BOX 22, LA VERGNE, TN 37086-0022
(615) 481-1685
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
01/11/2022
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