Organization
KINGDOM HOME CARE AGENCY LLC
Active
Other names
KINGDOM HOME CARE AGENCY LLC, KINGDOM HOME CARE AGENCY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DEJUANNA LASHAY PUCKETT (OWNER)
(575) 390-6707
Entity
Organization
Contact information
Practice address
3901 N CENTRAL DR APT 1043901N, HOBBS, NM 88240-1143
(575) 390-6707
Mailing address
3901 N CENTRAL DR APT 1043901N, HOBBS, NM 88240-1143
(575) 390-6707
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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