Kingdom Village Group Home
LBN: Kingdom Village Group Home
Kingdom Village Group Home is an health care organization with primary practice located at 3021 Greatbear Way , Kissimmee FL 34746-2116. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty.
Kingdom Village Group Home can be contacted via phone (330) 329-1588, or through Riley, Latosha via phone (330) 329-1588.
Contact Information
Primary practice address
3021 Greatbear Way
Kissimmee FL 34746-2116
Phone: (330) 329-1588
Fax: (407) 201-5348
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320900000X |
Profile Details
| NPI number | 1700539756 |
|---|---|
| LBN Legal business name | Kingdom Village Group Home |
| DBA Doing business as | |
| Authorized official | Riley, Latosha |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 31st, 2022 |
| Last updated | Jan 31st, 2022 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700539756 | NPPES |
| Florida | MEDICAID | 010293900 |
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