Basic Information
| Provider Information | |||||||||
| NPI: | 1871731356 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | K3D INDUSTRIES, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THE RIGHT PLACE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1881 NE 26TH ST | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | WILTON MANORS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333051416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545877771 | ||||||||
| FaxNumber: | 9542522346 | ||||||||
| Practice Location | |||||||||
| Address1: | 1780 NW 52ND AVE | ||||||||
| Address2: | |||||||||
| City: | LAUDERHILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333137811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545877771 | ||||||||
| FaxNumber: | 9542522346 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2009 | ||||||||
| LastUpdateDate: | 01/22/2009 | ||||||||
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| AuthorizedOfficialLastName: | KRAUS | ||||||||
| AuthorizedOfficialFirstName: | JOE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9545877771 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | 1706AD018001 | FL | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.