NPIMap

Organization Active NPI

Kyjo Enterprises, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Fresno, CA
National Provider Identifier
1831781343
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
KYJO ENTERPRISES, INC.
Practice address
2291 N Hazel Ave
Fresno, CA 93722-5562
Phone
(559) 243-7002
NPI assigned
Feb 5, 2021
Last updated
Nov 18, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
KYJO ENTERPRISES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Authorized official

Name
Kevin Dante Jordan
Title
Executive Director
Phone
(559) 243-7002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

2291 N Hazel Ave
Fresno, CA 93722-5562

Mailing address

114 E Shaw Ave Ste 210
Fresno, CA 93710-7621
Phone (559) 243-7002

Other names 1

  • Hazel House Other name

National Provider Directory

National Provider Directory
Tax ID family
Kyjo Enterprises Inc5 organizations share this tax ID, including this one
Part of
Kyjo Enterprises Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

114 E Shaw Ave
Ste 210
Fresno, CA 93710
Phone (559) 230-0920

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1831781343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E SHAW AVE STE 210",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107621",
            "telephone_number": "559-243-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2291 N HAZEL AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937225562",
            "telephone_number": "559-243-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYJO ENTERPRISES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KYJO ENTERPRISES, INC.",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DANTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "559-243-7002"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hazel House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.