Organization
KINGDOM CARE OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN GOLDBERG (MEDICARE AUTHORIZED OFFICIAL)
(443) 208-1826
Entity
Organization
Contact information
Practice address
811 CENTER ST, FULTON, MO 65251-1922
(573) 642-6646
(573) 642-2202
Mailing address
1605 UNION AVE, BALTIMORE, MD 21211-1918
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/02/2026
Last updated
04/02/2026
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