Organization
KINGDOM HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KETLY ANGOMA (OWNER)
(314) 620-6002
Entity
Organization
Contact information
Practice address
1001 NE 15TH ST, HOMESTEAD, FL 33030-4956
(314) 620-6002
Mailing address
1001 NE 15TH ST, HOMESTEAD, FL 33030-4956
(314) 620-6002
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
03/25/2022
Last updated
03/25/2022
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