Kings Personal Kare Facility Grp LLC

NPI #1811238306 in Ellenwood, Georgia

Provider Information

NPI Number: 1811238306
Entity Type: Organization
Organization Name: Kings Personal Kare Facility Grp LLC
Primary Specialty: Home Health
Enumeration Date: Mar 7, 2013
Last Updated: Mar 7, 2013

Practice Location

Address: 111 ELIZABETH WAY
City: Ellenwood
State: Georgia
ZIP Code: 30294-2820
Phone: (678) 869-5464

Authorized Official

Name: MRS. DIANE SPEARS
Title: EXECUTIVE DIRECTOR
Phone: (678) 472-3015

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health	251E00000X	Primary

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