# KINGS PASSION HOME CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124884184
- **Authorized official:** ANTHONY KEIFALA SAMAH (ADMINISTRATOR)
- **Authorized official phone:** (623) 225-2723

## Contact information

- **Practice address:** 2356 N SAND HILLS CT, CASA GRANDE, AZ 85122-6664
- **Practice address phone:** (632) 225-2723
- **Mailing address:** 2367 E OLIVINE RD, SAN TAN VALLEY, AZ 85143-4907
- **Mailing address phone:** (623) 225-2723

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/26/2024
- **Last updated:** 02/26/2024