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General NPI Number Information
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NPI Number | 1750702478
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Entity Type | Organization
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Legal Business Name | KINGSVIEW COUSELING SERVICES FOR KINGS COUNTY
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Dates
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Enumeration Date | 12/23/2013
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Last Update Date | 12/23/2013
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Provider Practice Location Address
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Address Line | 2811 W PEREZ CT
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City | VISALIA
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State | CA
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Zip | 93291-3129
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Country | US
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Telephone | 559-737-1370
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Fax |
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Provider Business Mailing Address
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Address Line | 2811 W PEREZ CT
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City | VISALIA
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State | CA
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Zip | 93291-3129
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Country | US
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Telephone | 559-737-1370
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Fax |
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Authorized Official
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Title or Position | AOD COUSELOR
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Name | MS. JENNIER JOHNSON MANGINE
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Credential | M1202071247
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Telephone | 559-582-4412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | M1202071247
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License Number State | CA
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