Organization
KDPK IV, INC.
Active
Organization
KDPK IV, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLORA KELLY (CEO)
(858) 583-6431
Entity
Organization
Contact information
Practice address
3810 GOVERNOR DR, SAN DIEGO, CA 92122-2441
(858) 583-6431
(858) 587-2802
Mailing address
6311 DENNISON ST, SAN DIEGO, CA 92122-2401
(858) 583-6431
(858) 587-2802
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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