1407246796 NPI number — KNR ENTERPRISES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407246796 NPI number — KNR ENTERPRISES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNR ENTERPRISES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOME HELPERS & DIRECT LINK OF VIRGINIA BEACH 58798
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407246796
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3096 MANSFIELD LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23457-1180
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-689-5966
Provider Business Mailing Address Fax Number:
757-689-5967

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2396 COURT PLAZA DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23456-3408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-689-5966
Provider Business Practice Location Address Fax Number:
757-689-5967
Provider Enumeration Date:
01/26/2015

Additional Information

Authorized Official

Authorized Official Last Name:
RENTZ
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
WYNNE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
757-615-3850

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HCO 151271 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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