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General NPI Number Information
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NPI Number | 1780876714
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Entity Type | Organization
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Legal Business Name | SERAH KINGS AGENCY
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | 220 PAWTUCKET ST FL 5
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City | LOWELL
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State | MA
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Zip | 01854-6800
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Country | US
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Telephone | 978-453-0500
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Fax | 978-453-0599
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Provider Business Mailing Address
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Address Line | 220 PAWTUCKET STREET SUITE 5
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City | LOWELL
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State | MA
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Zip | 01854
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Country | US
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Telephone | 978-453-0500
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Fax | 978-453-0599
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. SERAH NJERI KINGORI
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Credential | VICE PRESIDENT
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Telephone | 978-453-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7353
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License Number State | MA
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