Organization
KINGDOM CARE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRECE SCOTT (LLC MEMBER/OWNER)
(757) 319-3662
Entity
Organization
Contact information
Practice address
23 CARVER CIRCLE, PORTSMOUTH, VA 23701
(757) 319-3662
Mailing address
1517 CARSON CRES. EAST, PORTSMOUTH, VA 23701
(757) 319-3662
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
302F001
VA
Other
Enumeration date
06/22/2012
Last updated
06/22/2021
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