Organization
KINGDOM DEVELOPMENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERA DAVIS RN (PRESIDENT/CEO)
(252) 641-6400
Entity
Organization
Contact information
Practice address
2109 SAINT ANDREW ST, SUITE 12, TARBORO, NC 27886-2149
(252) 641-6400
(252) 641-6431
Mailing address
2109 SAINT ANDREW ST, SUITE 12, TARBORO, NC 27886-2149
(252) 641-6400
(252) 641-6431
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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