Organization
KINGDOM HOUSE LLC
Active
Other names
Rosa's Superior Home and Health Care Agency
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA MEDIOUS (OWNER/PRESIDENT)
(601) 783-0154
Entity
Organization
Contact information
Practice address
309 E BAY ST, MAGNOLIA, MS 39652-2815
(601) 783-0154
(601) 783-2995
Mailing address
309 E BAY ST, MAGNOLIA, MS 39652-2815
(601) 783-0154
(601) 783-2995
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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