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KINGDOM HEALTHCARE SERVICES NPI 1013667732


NPI Information

NPI: 1013667732
Provider Name: KINGDOM HEALTHCARE SERVICES
Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

CLIA Number: 10D2209566

Address:
1001 NE 15TH ST
HOMESTEAD, FL
ZIP 33030
Phone: (314) 620-6002
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KINGDOM HEALTHCARE SERVICES is a developmental disabilities clinic center in Homestead, FL. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). KINGDOM HEALTHCARE SERVICES NPI is 1013667732. The provider is registered as an organization entity type.

The provider's business location address is:

1001 NE 15TH ST
HOMESTEAD, FL
ZIP 33030-956
Phone: (314) 620-6002

The provider's authorized official is Ketly Angoma .
The authorized official title is Owner and has the following contact phone number (314) 620-6002.

The CLIA number assigned to this NPI record is 10D2209566 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/25/2022 and was last updated on 3/25/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD1600XClinic/CenterDevelopmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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