Provider Demographics
NPI:1528822780
Name:KALYE CREDIBLE LLC
Entity type:Organization
Organization Name:KALYE CREDIBLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-346-7177
Mailing Address - Street 1:403 MURRAY CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-1240
Mailing Address - Country:US
Mailing Address - Phone:916-770-4233
Mailing Address - Fax:916-898-0325
Practice Address - Street 1:403 MURRAY CT
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-1240
Practice Address - Country:US
Practice Address - Phone:916-770-4233
Practice Address - Fax:916-898-0325
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KALYE CREDIBLE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-08
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health