# A KINGDOM HEART HOME CARE LLC

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

## Provider details

- **NPI number:** 1134981087
- **Authorized official:** LACEY OWENS (ADMINISTRATOR)
- **Authorized official phone:** (912) 515-6944

## Contact information

- **Practice address:** 1511 JOHNS RD, AUGUSTA, GA 30904-4827
- **Practice address phone:** (912) 515-6944
- **Mailing address:** 1511 JOHNS RD, AUGUSTA, GA 30904-4827

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/26/2024
- **Last updated:** 01/26/2024