| Kaleidoverse Aba Llc | |
|
309 Lochvale Peak Ct Montgomery TX 77316-2183 | |
| (936) 242-2926 | |
| Not Available |
| Full Name | Kaleidoverse Aba Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 309 Lochvale Peak Ct, Montgomery, Texas |
| Authorized Official Name and Position | Kris Fritsche (CEO) |
| Authorized Official Contact | 9362422926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaleidoverse Aba Llc 309 Lochvale Peak Ct Montgomery TX 77316-2183 Ph: (936) 242-2926 | Kaleidoverse Aba Llc 309 Lochvale Peak Ct Montgomery TX 77316-2183 Ph: (936) 242-2926 |
| NPI Number | 1922859107 |
|---|---|
| Provider Enumeration Date | 03/27/2024 |
| Last Update Date | 03/27/2024 |
| Certification Date | 03/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922859107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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