Provider Demographics
NPI:1053544452
Name:KREW ENTERPRISES, INC DBA COMFORT KEEPERS 490
Entity type:Organization
Organization Name:KREW ENTERPRISES, INC DBA COMFORT KEEPERS 490
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEZLIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SNOOZY-KAITFORS
Authorized Official - Suffix:
Authorized Official - Credentials:GCMC
Authorized Official - Phone:605-717-4444
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-7267
Mailing Address - Country:US
Mailing Address - Phone:605-717-4444
Mailing Address - Fax:
Practice Address - Street 1:119 E GRANT ST
Practice Address - Street 2:STE 1
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-2408
Practice Address - Country:US
Practice Address - Phone:605-717-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health