Organization
KMG HOLDINGS, INC.
Active
Other names
The Lighthouse
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KORY KALE (CEO)
(919) 795-4438
Entity
Organization
Contact information
Practice address
10307 S. OAK ST., SUITE C, MIDDLESEX, NC 27557
(919) 795-4438
(919) 882-6311
Mailing address
PO BOX 24914, RALEIGH, NC 27611
(919) 795-4438
(919) 882-6311
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-051114
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603214
—
NC
Enumeration date
03/23/2007
Last updated
06/08/2023
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