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Organization
KINGSBROOK SENIOR CARE
Active
Organization
KINGSBROOK SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TEMITAYO SODIMU NURSE PRACTITIONER (DIRECTOR)
(817) 202-5752
Entity
Organization
Contact information
Practice address
521 E BOLT ST, FORT WORTH, TX 76110-6310
(817) 202-5752
Mailing address
1921 KINGSBROOK TRL, FORT WORTH, TX 76120-5081
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
11/01/2010
Last updated
01/31/2013
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