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General NPI Number Information
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NPI Number | 1821806761
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Entity Type | Organization
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Legal Business Name | KINGS QUEENS & CELEBRITIES, SPC
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Dates
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Enumeration Date | 12/24/2024
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 13718 PACIFIC AVE S
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City | TACOMA
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State | WA
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Zip | 98444-4746
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Country | US
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Telephone | 253-536-4580
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Fax | 253-584-2469
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Provider Business Mailing Address
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Address Line | PO BOX 44836
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City | TACOMA
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State | WA
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Zip | 98448-0836
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Country | US
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Telephone | 253-536-4580
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Fax | 253-584-2469
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Authorized Official
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Title or Position | PRINCIPLE / CAO / GENERAL MANAGER
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Name | JACQUEITA BELL
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Credential | CPC, CM
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Telephone | 253-536-4580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health 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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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