Organization
KATHLEEN BEATRICE KING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL J WATERMAN LCSW, PH.D (PRESIDENT)
(305) 305-2326
Entity
Organization
Contact information
Practice address
20340 NW 29TH CT, MIAMI GARDENS, FL 33056-1903
(305) 305-2326
Mailing address
20340 NW 29TH CT, MIAMI GARDENS, FL 33056-1903
(305) 305-2326
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
SW 13403
FL
251B00000X
Case Management Agency
SW 13403
FL
252Y00000X
Early Intervention Provider Agency
Primary
SW 13403
FL
253Z00000X
In Home Supportive Care Agency
SW 13403
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW 13403
DIVISION OF MEDICAL QUALITY ASSURANCE
FL
Enumeration date
02/03/2016
Last updated
07/25/2016
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