Organization
K'S HOUSE
Active
Organization
K'S HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYE S CRUMBLEY (OWNER/DIRECTOR)
(770) 474-5800
Entity
Organization
Contact information
Practice address
5556 SHOSHONE PASS, ELLENWOOD, GA 30294-6677
(770) 474-5800
(770) 474-6444
Mailing address
5556 SHOSHONE PASS, ELLENWOOD, GA 30294
(770) 474-5800
(770) 474-6444
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
667111020A
—
GA
Enumeration date
11/02/2010
Last updated
11/02/2010
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