Organization
KINGSLEY HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH LIEDERMAN PHD (EXECUTIVE DIRECTOR)
(504) 523-6221
Entity
Organization
Contact information
Practice address
1600 CONSTANCE STREET, NEW ORLEANS, LA 70130-4641
(504) 523-6221
(504) 523-4450
Mailing address
1600 CONSTANCE STREET, NEW ORLEANS, LA 70130-4641
(504) 523-6221
(504) 523-4450
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
0002525
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1317306
—
LA
Enumeration date
05/11/2007
Last updated
08/22/2020
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