Kechi Supported Living, Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

KECHI SUPPORTED LIVING, INC

Practice address

51079 Lone Tree Way
Antioch, CA 94531-8689

Phone

(925) 476-8872

Fax

(925) 679-7067

NPI assigned

Nov 8, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sariette Metagheu

Title

Executive Director

Phone

(925) 476-8872

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385510400000",
    "number": "1558790618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 LAKE PARK DR",
            "city": "OAKLEY",
            "state": "CA",
            "postal_code": "945613510",
            "telephone_number": "510-472-6259",
            "fax_number": "925-679-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51079 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318689",
            "telephone_number": "925-476-8872",
            "fax_number": "925-679-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KECHI SUPPORTED LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-27",
        "status": "A",
        "authorized_official_last_name": "METAGHEU",
        "authorized_official_first_name": "SARIETTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "925-476-8872"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ishjot Kaur, LVN
• Jasdeep Kaur
• Manjinder Kaur
• Manjit Kaur
• Gabrielle Keane
• Nichelle Keffler-Roa, DPT
• Serena Lachelle Kelly
• Valerie Kemp
• Robert Ford Kennedy
• Mahmood Ketabchi, LMFT

• In Home Supportive Care Agency in Antioch, CA
• Providers in Antioch, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.