Davis, Kenneth Lee

Davis, Kenneth Lee is an individual health care provider with primary practice located at 184 Unser Blvd Ne , Rio Rancho NM 87124-4045. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Davis, Kenneth Lee can be contacted via phone (505) 896-0928.

Contact Information

Primary practice address
184 Unser Blvd Ne Rio Rancho NM 87124-4045
Phone: (505) 896-0928
Fax: (504) 994-0209
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X RC00056544 Washington
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1023143021
LBN Legal business name Davis, Kenneth Lee
Credentials CPSW, CPSC, MSD, DD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2007
Last updated Apr 25th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023143021 NPPES
New Mexico MEDICAID 44842

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