Organization
KINGDOM HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE E HANSLEY (AGENCY DIRECTOR)
(252) 353-5522
Entity
Organization
Contact information
Practice address
1530 EVANS ST, STE 211, GREENVILLE, NC 27834-5301
(252) 353-5522
(252) 353-5330
Mailing address
1530 EVANS ST, STE 211, GREENVILLE, NC 27834-5301
(252) 353-5522
(252) 353-5330
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC3221
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418063
—
NC
05
—
6601409
—
NC
Enumeration date
03/19/2007
Last updated
09/02/2009
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