Organization
KINGS & QUEENS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAMEEKA KELLY RN (DON)
(731) 343-8684
Entity
Organization
Contact information
Practice address
118 DEVONSHIRE SQ, SUITE 7, JACKSON, TN 38305-2255
(731) 343-8684
Mailing address
124 CHESTER LEVEE RD, JACKSON, TN 38301-7562
(731) 343-8684
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
212116
TN
251J00000X
Nursing Care Agency
Primary
83001
TN
253Z00000X
In Home Supportive Care Agency
17750
TN
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
17750
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q020832
—
TN
Enumeration date
12/18/2015
Last updated
06/17/2016
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