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Organization
KINGDOM HOUSE LLC
Active
Organization
KINGDOM HOUSE LLC
Active
Other names
Rosa's Superior Home and Health Care Agency
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA MEDIOUS (OWNER/PRESIDENT)
(601) 783-0154
Entity
Organization
Contact information
Practice address
309 E BAY ST, MAGNOLIA, MS 39652-2815
(601) 783-0154
(601) 783-2995
Mailing address
309 E BAY ST, MAGNOLIA, MS 39652-2815
(601) 783-0154
(601) 783-2995
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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