Healthcare Provider Details

I. General information

NPI: 1851225577
Provider Name (Legal Business Name): KINGDOM CARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1434A W MARKET ST
ANDERSON SC
29624-1328
US

IV. Provider business mailing address

1434A W MARKET ST
ANDERSON SC
29624-1328
US

V. Phone/Fax

Practice location:
  • Phone: 864-642-9642
  • Fax: 864-686-5777
Mailing address:
  • Phone: 864-642-9642
  • Fax: 864-686-5777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ADRAIN LETISHA PATTERSON
Title or Position: OWNER
Credential: RN ADMINISTRATOR
Phone: 864-221-1441