=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174477517
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KINGDOM CHOICE HEALTHCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2026
-----------------------------------------------------
Last Update Date | 02/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 744 LEMAY FERRY RD
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63125-1428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-226-9106
-----------------------------------------------------
Fax | 314-226-9107
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1944
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63118-0144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-226-9106
-----------------------------------------------------
Fax | 314-226-9107
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LORESSA WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 442-446-8059
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------