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General NPI Number Information
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NPI Number | 1720821820
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Entity Type | Organization
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Legal Business Name | KING MINISTRIEZ
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Dates
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Enumeration Date | 06/17/2024
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 3819 HAPPY CANYON DR
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City | DALLAS
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State | TX
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Zip | 75241-5230
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Country | US
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Telephone | 978-962-9754
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Fax |
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Provider Business Mailing Address
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Address Line | 3655 SIMPSON STUART RD UNIT 41324
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City | DALLAS
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State | TX
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Zip | 75241-4346
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Country | US
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Telephone | 978-962-9754
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FREDDIE JACKSON
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Credential |
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Telephone | 978-962-9754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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