Organization
KYNGDOM SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE RIVERS (OWNER)
(407) 674-8988
Entity
Organization
Contact information
Practice address
750 S ORANGE BLOSSOM TRL, 227, ORLANDO, FL 32805-3118
(407) 674-8988
(407) 674-8992
Mailing address
750 S ORANGE BLOSSOM TRL, 227, ORLANDO, FL 32805-3118
(407) 674-8988
(407) 674-8992
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003575300
—
FL
Enumeration date
04/02/2014
Last updated
10/03/2014
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