Organization
KINGDOM SONS LEGACY HOUSE CORP
Active
Parent organization
JACK C. MONTGOMERY VA MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACK C. MONTGOMERY VA MEDICAL CENTER
Authorized official
KRYSTAL RODGERS (FOUNDER/CEO)
(706) 668-8169
Entity
Organization
Contact information
Practice address
8531 ZANE LN, PORT RICHEY, FL 34668-1261
(706) 668-8169
Mailing address
8531 ZANE LN, PORT RICHEY, FL 34668-1261
(706) 668-8169
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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