Organization
KINGDOM HEART LIVING LLC
Active
Organization
KINGDOM HEART LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAXINE COSTON (CEO)
(336) 405-1015
Entity
Organization
Contact information
Practice address
1165 GLENSTONE TRL APT 2C, HIGH POINT, NC 27265-7489
(336) 405-1015
Mailing address
1165 GLENSTONE TRL APT 2C, HIGH POINT, NC 27265-7489
(336) 405-1015
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/20/2026
Last updated
01/20/2026
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