Organization
KBCM & SUPPORT BROKER SERVICES
Active
Other names
KBCM & Support Broker Services Corp.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIM HANNAH (CEO)
(803) 262-3464
Entity
Organization
Contact information
Practice address
631 E GARRISON BLVD STE C, GASTONIA, NC 28054-4472
(704) 215-5469
(704) 396-6931
Mailing address
631 E GARRISON BLVD STE C, GASTONIA, NC 28054-4472
(704) 215-5469
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
—
—
251B00000X
Case Management Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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