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Organization
KINGDOM CARE AGENCY LLC
Active
Organization
KINGDOM CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAYANNA LEWIS (OWNER/ FOUNDER)
(339) 208-2001
Entity
Organization
Contact information
Practice address
2 GRANITE AVE STE 260, MILTON, MA 02186
(339) 987-6499
Mailing address
68 HARRISON AVE STE 605, BOSTON, MA 02111-1929
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
NULL
251J00000X
Nursing Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
283XC2000X
Children's Rehabilitation Hospital
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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