# KINGSBROOK SENIOR CARE

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

## Provider details

- **NPI number:** 1225338684
- **Authorized official:** MRS. TEMITAYO SODIMU NURSE PRACTITIONER (DIRECTOR)
- **Authorized official phone:** (817) 202-5752

## Contact information

- **Practice address:** 521 E BOLT ST, FORT WORTH, TX 76110-6310
- **Practice address phone:** (817) 202-5752
- **Mailing address:** 1921 KINGSBROOK TRL, FORT WORTH, TX 76120-5081

## Taxonomy

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

## Other

- **Enumeration date:** 11/01/2010
- **Last updated:** 01/31/2013