| NPI | 1194321067 |
|---|---|
| Doing Business As | KICKS LCC |
| Entity Type | Organization |
| Authorized Contact | DIANA SPAIN Co Owner 740-348-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2020-12-07 |