Kccdd, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

KCCDD, INC.

Practice address

2015 Windish Dr
Galesburg, IL 61401-9774

Phone

(309) 344-2600

Fax

(309) 344-1754

NPI assigned

Jul 2, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Mark Edwin Rudolph

Title

Chief Executive Officer

Phone

(309) 344-2600

Specialties & licenses 2

Addresses

Tax ID family

Kccdd Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Kccdd, Inc.

  • Adult Mental Health Clinic/Center
  • Galesburg, IL
  • NPI 1083557060
  NPD tax ID

Locations

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567728000000",
    "number": "1881857514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 WINDISH DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614019774",
            "telephone_number": "309-344-2600",
            "fax_number": "309-344-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 WINDISH DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614019774",
            "telephone_number": "309-344-2600",
            "fax_number": "309-344-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCCDD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2019-09-06",
        "status": "A",
        "authorized_official_last_name": "RUDOLPH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "309-344-2600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A000103309",
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Kelly Kane, M.D.
• Dan Wilbert Kaspar, DDS,MS
• Virginia G Kasser, PH.D.
• Marc Katchen, MD
• Kccdd, Inc.
• Kehoe Eye Care PC
• Peter H Kehoe, OD
• Kensington of Galesburg
• B. S. Kesavan, M.D.
• Jamie Christine Key, LPN

• Adult Day Care Clinic/Center in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Adult Day Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.